Bill Text: OH SB134 | 2009-2010 | 128th General Assembly | Introduced


Bill Title: ; to amend Section 7 of Am. Sub. H.B. 468 of the 126th General Assembly; to create the Department of Health Care Administration; to transfer the Medicaid Program, Children's Health Insurance Program, Children's Buy-In Program, Hospital Care Assurance Program, Disability Medical Assistance Program, Ohio's Best Rx Program, and Residential State Supplement Program to the new department; to require the new department to create a central pharmaceutical purchasing office; and to make an appropriation.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2009-06-16 - To Finance & Financial Institutions [SB134 Detail]

Download: Ohio-2009-SB134-Introduced.html
As Introduced

128th General Assembly
Regular Session
2009-2010
S. B. No. 134


Senator Miller, R. 



A BILL
To amend sections 9.231, 9.239, 9.24, 101.39, 1
101.391, 103.144, 109.572, 109.85, 117.10, 119.01, 2
121.02, 121.03, 122.15, 124.30, 124.301, 127.16, 3
131.23, 145.27, 145.58, 149.431, 169.02, 173.14, 4
173.20, 173.21, 173.26, 173.35, 173.351, 173.394, 5
173.40, 173.401, 173.42, 173.45, 173.47, 173.50, 6
173.71, 173.72, 173.721, 173.722, 173.723, 7
173.724, 173.73, 173.731, 173.732, 173.74, 8
173.741, 173.742, 173.75, 173.751, 173.752, 9
173.753, 173.76, 173.77, 173.771, 173.772, 10
173.773, 173.78, 173.79, 173.791, 173.80, 11
173.801, 173.802, 173.803, 173.81, 173.811, 12
173.812, 173.813, 173.814, 173.815, 173.82, 13
173.83, 173.831, 173.832, 173.833, 173.84, 14
173.85, 173.86, 173.861, 173.87, 173.88, 173.89, 15
173.891, 173.892, 173.90, 173.91, 173.99, 317.08, 16
317.36, 323.01, 329.04, 329.051, 329.06, 329.14, 17
340.03, 340.091, 340.16, 341.192, 505.84, 742.41, 18
955.201, 1337.11, 1347.08, 1731.04, 1739.061, 19
1751.01, 1751.11, 1751.12, 1751.18, 1751.271, 20
1751.31, 1751.60, 1751.88, 1751.89, 1923.14, 21
2113.041, 2113.06, 2117.061, 2117.25, 2133.01, 22
2151.3514, 2305.234, 2307.65, 2317.02, 2335.39, 23
2505.02, 2705.02, 2744.05, 2903.33, 2913.40, 24
2913.401, 2921.01, 2921.13, 2945.401, 3101.051, 25
3107.083, 3111.04, 3111.72, 3113.06, 3119.29, 26
3119.54, 3121.441, 3121.898, 3125.36, 3307.20, 27
3309.22, 3313.714, 3313.715, 3323.021, 3599.45, 28
3701.023, 3701.024, 3701.027, 3701.043, 3701.132, 29
3701.243, 3701.507, 3701.74, 3701.741, 3701.881, 30
3702.30, 3702.31, 3702.51, 3702.522, 3702.591, 31
3702.62, 3702.74, 3702.91, 3712.07, 3712.09, 32
3721.01, 3721.011, 3721.021, 3721.022, 3721.024, 33
3721.026, 3721.042, 3721.071, 3721.08, 3721.10, 34
3721.12, 3721.121, 3721.13, 3721.15, 3721.16, 35
3721.17, 3721.19, 3721.21, 3721.28, 3721.32, 36
3721.50, 3721.51, 3721.52, 3721.53, 3721.54, 37
3721.541, 3721.55, 3721.56, 3721.561, 3721.57, 38
3721.58, 3722.10, 3722.16, 3727.02, 3742.30, 39
3742.51, 3793.07, 3901.3814, 3903.14, 3916.06, 40
3923.122, 3923.27, 3923.281, 3923.33, 3923.38, 41
3923.49, 3923.50, 3923.58, 3923.601, 3923.70, 42
3923.79, 3923.83, 3924.41, 3924.42, 3963.01, 43
4123.27, 4141.162, 4719.01, 4723.063, 4723.17, 44
4723.63, 4731.151, 4731.65, 4731.71, 4752.02, 45
4752.09, 4753.071, 4755.481, 4758.02, 4758.04, 46
4761.01, 4761.03, 4769.01, 5101.07, 5101.071, 47
5101.11, 5101.16, 5101.162, 5101.18, 5101.181, 48
5101.182, 5101.184, 5101.21, 5101.212, 5101.214, 49
5101.216, 5101.22, 5101.221, 5101.23, 5101.24, 50
5101.243, 5101.25, 5101.26, 5101.31, 5101.35, 51
5101.36, 5101.47, 5101.50, 5101.501, 5101.502, 52
5101.503, 5101.51, 5101.511, 5101.512, 5101.513, 53
5101.514, 5101.515, 5101.516, 5101.517, 5101.518, 54
5101.519, 5101.5110, 5101.52, 5101.521, 5101.522, 55
5101.523, 5101.524, 5101.525, 5101.526, 5101.527, 56
5101.528, 5101.529, 5101.5211, 5101.5212, 57
5101.5213, 5101.5214, 5101.5215, 5101.5216, 58
5101.571, 5101.572, 5101.573, 5101.575, 5101.58, 59
5101.59, 5101.591, 5101.97, 5103.02, 5107.10, 60
5107.14, 5107.16, 5107.20, 5107.26, 5111.01, 61
5111.011, 5111.013, 5111.014, 5111.015, 5111.016, 62
5111.018, 5111.019, 5111.0110, 5111.0111, 63
5111.0112, 5111.0113, 5111.0114, 5111.0115, 64
5111.0116, 5111.0117, 5111.0118, 5111.0119, 65
5111.02, 5111.021, 5111.022, 5111.023, 5111.024, 66
5111.025, 5111.028, 5111.029, 5111.03, 5111.031, 67
5111.032, 5111.033, 5111.034, 5111.04, 5111.042, 68
5111.05, 5111.06, 5111.061, 5111.062, 5111.07, 69
5111.071, 5111.08, 5111.081, 5111.082, 5111.083, 70
5111.084, 5111.09, 5111.091, 5111.10, 5111.102, 71
5111.11, 5111.111, 5111.112, 5111.113, 5111.114, 72
5111.12, 5111.121, 5111.13, 5111.14, 5111.15, 73
5111.151, 5111.16, 5111.162, 5111.163, 5111.17, 74
5111.171, 5111.172, 5111.173, 5111.174, 5111.175, 75
5111.176, 5111.177, 5111.178, 5111.18, 5111.181, 76
5111.19, 5111.191, 5111.20, 5111.201, 5111.202, 77
5111.203, 5111.204, 5111.21, 5111.211, 5111.22, 78
5111.221, 5111.222, 5111.23, 5111.231, 5111.232, 79
5111.235, 5111.24, 5111.241, 5111.242, 5111.243, 80
5111.244, 5111.25, 5111.251, 5111.254, 5111.255, 81
5111.258, 5111.26, 5111.261, 5111.263, 5111.264, 82
5111.265, 5111.266, 5111.27, 5111.28, 5111.29, 83
5111.291, 5111.30, 5111.31, 5111.32, 5111.33, 84
5111.34, 5111.35, 5111.36, 5111.37, 5111.38, 85
5111.39, 5111.41, 5111.411, 5111.42, 5111.43, 86
5111.44, 5111.45, 5111.46, 5111.47, 5111.48, 87
5111.49, 5111.50, 5111.51, 5111.52, 5111.53, 88
5111.54, 5111.55, 5111.56, 5111.57, 5111.58, 89
5111.59, 5111.60, 5111.61, 5111.62, 5111.63, 90
5111.65, 5111.651, 5111.66, 5111.67, 5111.671, 91
5111.672, 5111.673, 5111.674, 5111.675, 5111.676, 92
5111.677, 5111.68, 5111.681, 5111.682, 5111.683, 93
5111.684, 5111.685, 5111.686, 5111.687, 5111.688, 94
5111.70, 5111.701, 5111.702, 5111.703, 5111.704, 95
5111.705, 5111.707, 5111.708, 5111.709, 5111.7010, 96
5111.7011, 5111.71, 5111.711, 5111.712, 5111.713, 97
5111.714, 5111.715, 5111.84, 5111.85, 5111.851, 98
5111.852, 5111.853, 5111.855, 5111.856, 5111.86, 99
5111.87, 5111.871, 5111.872, 5111.873, 5111.874, 100
5111.875, 5111.876, 5111.877, 5111.878, 5111.879, 101
5111.8710, 5111.89, 5111.891, 5111.894, 5111.90, 102
5111.91, 5111.911, 5111.912, 5111.913, 5111.914, 103
5111.915, 5111.92, 5111.93, 5111.94, 5111.941, 104
5111.942, 5111.943, 5111.97, 5111.971, 5111.98, 105
5111.99, 5112.01, 5112.03, 5112.04, 5112.05, 106
5112.06, 5112.07, 5112.08, 5112.09, 5112.10, 107
5112.11, 5112.17, 5112.18, 5112.19, 5112.21, 108
5112.30, 5112.31, 5112.32, 5112.33, 5112.34, 109
5112.341, 5112.35, 5112.37, 5112.371, 5112.38, 110
5112.39, 5112.99, 5115.02, 5115.10, 5115.11, 111
5115.12, 5115.13, 5115.14, 5115.20, 5115.22, 112
5115.23, 5117.10, 5119.04, 5119.061, 5119.16, 113
5119.351, 5119.61, 5120.65, 5120.652, 5121.04, 114
5123.01, 5123.021, 5123.0412, 5123.0417, 115
5123.171, 5123.181, 5123.19, 5123.192, 5123.198, 116
5123.211, 5123.71, 5123.76, 5126.01, 5126.042, 117
5126.046, 5126.054, 5126.055, 5126.0512, 118
5126.082, 5126.12, 5302.221, 5309.082, 5505.04, 119
5725.18, 5729.03, 5731.39, 5747.01, 5747.122, 120
5747.18, 5751.081, 5815.28, and 5907.04, to 121
amend, for the purpose of adopting a new section 122
number as indicated in parentheses sections 123
173.35 (5160.80), 173.351 (5160.81), 173.71 124
(5169.01), 173.72 (5169.02), 173.721 (5169.021), 125
173.722 (5169.022), 173.723 (5169.023), 173.724 126
(5169.024), 173.73 (5169.03), 173.731 (5169.031), 127
173.732 (5169.032), 173.74 (5169.04), 173.741 128
(5169.041), 173.742 (5169.042), 173.75 (5169.05), 129
173.751 (5169.051), 173.752 (5169.052), 173.753 130
(5169.053), 173.76 (5169.06), 173.77 (5169.07), 131
173.771 (5169.071), 173.772 (5169.072), 173.773 132
(5169.073), 173.78 (5169.08), 173.79 (5169.09), 133
173.791 (5169.091), 173.80 (5169.10), 173.801 134
(5169.101), 173.802 (5169.102), 173.803 135
(5169.103), 173.81 (5169.11), 173.811 (5169.111), 136
173.812 (5169.112), 173.813 (5169.113), 173.814 137
(5169.114), 173.815 (5169.115), 173.82 (5169.12), 138
173.83 (5169.13), 173.831 (5169.131), 173.832 139
(5169.132), 173.833 (5169.133), 173.84 (5169.14), 140
173.85 (5169.15), 173.86 (5169.16), 173.861 141
(5169.161), 173.87 (5169.17), 173.871 (5169.171), 142
173.872 (5169.172), 173.873 (5169.173), 173.874 143
(5169.174), 173.875 (5169.175), 173.876 144
(5169.176), 173.88 (5169.18), 173.89 (5169.19), 145
173.891 (5169.191), 173.892 (5169.192), 173.90 146
(5169.20), 173.91 (5169.21), 3721.50 (5166.20), 147
3721.51 (5166.21), 3721.52 (5166.22), 3721.53 148
(5166.23), 3721.54 (5166.24), 3721.541 (5166.25), 149
3721.55 (5166.26), 3721.56 (5166.27), 3721.561 150
(5166.28), 3721.57 (5166.29), 3721.58 (5166.30), 151
5101.31 (5160.67), 5101.50 (5167.05), 5101.501 152
(5167.06), 5101.502 (5167.07), 5101.503 (5167.08), 153
5101.51 (5167.10), 5101.511 (5167.11), 5101.512 154
(5167.12), 5101.513 (5167.13), 5101.514 (5167.14), 155
5101.515 (5167.15), 5101.516 (5167.16), 5101.517 156
(5167.17), 5101.518 (5167.18), 5101.519 (5167.19), 157
5101.5110 (5167.32), 5101.52 (5167.21), 5101.521 158
(5167.22), 5101.522 (5167.23), 5101.523 (5167.24), 159
5101.524 (5167.25), 5101.525 (5167.26), 5101.526 160
(5167.27), 5101.527 (5167.28), 5101.528 (5167.29), 161
5101.529 (5167.30), 5101.5211 (5167.35), 5101.5212 162
(5167.36), 5101.5213 (5167.37), 5101.5214 163
(5167.38), 5101.5215 (5167.39), 5101.5216 164
(5167.40), 5101.571 (5160.36), 5101.572 165
(5160.40), 5101.573 (5160.401), 5101.574 166
(5160.402), 5101.575 (5160.403), 5101.58 167
(5160.38), 5101.59 (5160.37), 5101.591 (5160.41), 168
5111.01 (5162.01), 5111.011 (5162.20), 5111.013 169
(5162.15), 5111.014 (5162.04), 5111.015 (5162.24), 170
5111.016 (5162.16), 5111.018 (5163.18), 5111.019 171
(5162.05), 5111.0110 (5162.08), 5111.0111 172
(5162.06), 5111.0112 (5162.35), 5111.0113 173
(5162.07), 5111.0114 (5163.261), 5111.0115 174
(5162.09), 5111.0116 (5162.21), 5111.0117 175
(5162.22), 5111.0118 (5162.23), 5111.0119 176
(5162.18), 5111.02 (5163.15), 5111.021 (5163.16), 177
5111.022 (5163.08), 5111.023 (5163.20), 5111.024 178
(5163.19), 5111.025 (5163.17), 5111.027 179
(5163.242), 5111.028 (5163.011), 5111.029 180
(5163.27), 5111.03 (5163.03), 5111.031 (5163.031), 181
5111.032 (5163.032), 5111.033 (5163.033), 5111.034 182
(5163.034), 5111.04 (5163.21), 5111.042 183
(5163.28), 5111.05 (5163.02), 5111.06 (5163.01), 184
5111.061 (5163.07), 5111.062 (5163.09), 5111.07 185
(5163.25), 5111.071 (5163.251), 5111.08 186
(5163.241), 5111.081 (5163.26), 5111.082 187
(5163.24), 5111.083 (5163.243), 5111.084 188
(5160.04), 5111.09 (5161.32), 5111.091 (5161.33), 189
5111.10 (5161.30), 5111.101 (5163.12), 5111.102 190
(5161.011), 5111.11 (5162.40), 5111.111 191
(5162.41), 5111.112 (5162.42), 5111.113 192
(5162.37), 5111.114 (5162.36), 5111.12 (5162.45), 193
5111.121 (5160.39), 5111.13 (5165.30), 5111.14 194
(5163.22), 5111.15 (5162.25), 5111.151 (5162.26), 195
5111.16 (5165.03), 5111.162 (5165.14), 5111.163 196
(5165.15), 5111.17 (5165.05), 5111.171 (5165.07), 197
5111.172 (5165.09), 5111.173 (5165.10), 5111.174 198
(5165.12), 5111.175 (5165.13), 5111.176 199
(5166.60), 5111.177 (5165.11), 5111.178 200
(5165.16), 5111.18 (5162.43), 5111.181 (5162.30), 201
5111.19 (5163.23), 5111.191 (5163.231), 5111.20 202
(5164.01), 5111.201 (5164.011), 5111.202 203
(5164.45), 5111.203 (5164.46), 5111.204 (5164.47), 204
5111.21 (5164.02), 5111.211 (5164.14), 5111.22 205
(5164.03), 5111.221 (5164.40), 5111.222 (5164.18), 206
5111.223 (5164.031), 5111.23 (5164.05), 5111.231 207
(5164.19), 5111.232 (5164.191), 5111.235 208
(5164.06), 5111.24 (5164.20), 5111.241 (5164.07), 209
5111.242 (5164.21), 5111.243 (5164.22), 5111.244 210
(5164.23), 5111.25 (5164.24), 5111.251 (5164.08), 211
5111.254 (5164.32), 5111.255 (5164.12), 5111.257 212
(5164.27), 5111.258 (5164.34), 5111.26 (5164.37), 213
5111.261 (5164.10), 5111.263 (5164.26), 5111.264 214
(5164.372), 5111.265 (5164.28), 5111.266 215
(5164.371), 5111.27 (5164.38), 5111.28 (5164.39), 216
5111.29 (5164.41), 5111.291 (5164.13), 5111.30 217
(5164.032), 5111.31 (5164.033), 5111.32 218
(5164.034), 5111.33 (5164.35), 5111.34 (5164.30), 219
5111.35 (5164.50), 5111.36 (5164.51), 5111.37 220
(5164.52), 5111.38 (5164.53), 5111.39 (5164.54), 221
5111.40 (5164.55), 5111.41 (5164.56), 5111.411 222
(5164.57), 5111.42 (5164.58), 5111.43 (5164.59), 223
5111.44 (5164.60), 5111.45 (5164.61), 5111.46 224
(5164.62), 5111.47 (5164.63), 5111.48 (5164.64), 225
5111.49 (5164.65), 5111.50 (5164.66), 5111.51 226
(5164.67), 5111.52 (5164.68), 5111.53 (5164.69), 227
5111.54 (5164.70), 5111.55 (5164.71), 5111.56 228
(5164.72), 5111.57 (5164.73), 5111.58 (5164.74), 229
5111.59 (5164.75), 5111.60 (5164.76), 5111.61 230
(5164.77), 5111.62 (5164.78), 5111.63 (5164.79), 231
5111.65 (5164.82), 5111.651 (5164.821), 5111.66 232
(5164.83), 5111.67 (5164.84), 5111.671 (5164.841), 233
5111.672 (5164.842), 5111.673 (5164.843), 5111.674 234
(5164.844), 5111.675 (5164.845), 5111.676 235
(5164.846), 5111.677 (5164.847), 5111.68 236
(5164.85), 5111.681 (5164.851), 5111.682 237
(5164.852), 5111.683 (5164.853), 5111.684 238
(5164.854), 5111.685 (5164.855), 5111.686 239
(5164.856), 5111.687 (5164.857), 5111.688 240
(5164.858), 5111.70 (5162.10), 5111.701 241
(5162.101), 5111.702 (5162.102), 5111.703 242
(5162.103), 5111.704 (5162.104) 5111.705 243
(5162.105), 5111.706 (5162.106), 5111.707 244
(5162.107), 5111.708 (5162.108), 5111.709 245
(5162.109), 5111.7010 (5162.1010), 5111.7011 246
(5162.1011), 5111.71 (5163.30), 5111.711 247
(5163.301), 5111.712 (5163.302), 5111.713 248
(5163.303), 5111.714 (5163.304), 5111.715 249
(5163.305), 5111.84 (5163.501), 5111.85 (5163.50), 250
5111.851 (5163.51), 5111.852 (5163.52), 5111.853 251
(5163.53), 5111.854 (5163.54), 5111.855 252
(5163.55), 5111.856 (5163.56), 5111.86 (5163.60), 253
5111.87 (5163.65), 5111.871 (5163.651), 5111.872 254
(5163.652), 5111.873 (5163.653), 5111.874 255
(5163.66), 5111.875 (5163.661), 5111.876 256
(5163.662), 5111.877 (5163.663), 5111.878 257
(5163.664), 5111.879 (5163.665), 5111.8710 258
(5163.666), 5111.89 (5163.68), 5111.891 259
(5163.681), 5111.892 (5163.682), 5111.893 260
(5163.683), 5111.894 (5163.684), 5111.90 261
(5161.10), 5111.91 (5161.05), 5111.911 (5161.06), 262
5111.912 (5161.07), 5111.913 (5161.08), 5111.914 263
(5163.06), 5111.915 (5161.25), 5111.92 (5161.12), 264
5111.93 (5161.13), 5111.94 (5161.15), 5111.941 265
(5161.16), 5111.942 (5161.17), 5111.943 266
(5161.18), 5111.97 (5163.73), 5111.971 (5163.69), 267
5111.98 (5161.02), 5111.99 (5164.99), 5112.01 268
(5166.01), 5112.03 (5166.02), 5112.04 (5166.03), 269
5112.05 (5166.04), 5112.06 (5166.05), 5112.07 270
(5166.06), 5112.08 (5166.07), 5112.09 (5166.08), 271
5112.10 (5166.09), 5112.11 (5166.10), 5112.17 272
(5166.11), 5112.18 (5166.12), 5112.19 (5166.13), 273
5112.21 (5166.14), 5112.30 (5166.40), 5112.31 274
(5166.41), 5112.32 (5166.43), 5112.33 (5166.44), 275
5112.34 (5166.45), 5112.341 (5166.46), 5112.35 276
(5166.47), 5112.37 (5166.48), 5112.371 (5166.481), 277
5112.38 (5166.49), 5112.39 (5166.50), 5112.99 278
(5166.99), 5115.10 (5168.01), 5115.11 (5168.02), 279
5115.12 (5168.05), 5115.13 (5168.07), 5115.14 280
(5168.06), to enact sections 117.54, 117.55, 281
117.56, 117.57, 329.043, 5160.01, 5160.02, 282
5160.03, 5160.05, 5160.06, 5160.08, 5160.10, 283
5160.101, 5160.12, 5160.13, 5160.15, 5160.151, 284
5160.152, 5160.17, 5160.18, 5160.19, 5160.191, 285
5160.192, 5160.20, 5160.21, 5160.211, 5160.22, 286
5160.23, 5160.24, 5160.26, 5160.261, 5160.262, 287
5160.28, 5160.29, 5160.30, 5160.32, 5160.34, 288
5160.341, 5160.42, 5160.43, 5160.44, 5160.45, 289
5160.46, 5160.50, 5160.51, 5160.52, 5160.53, 290
5160.54, 5160.55, 5160.56, 5160.57, 5160.58, 291
5160.59, 5160.60, 5160.61, 5160.62, 5160.63, 292
5160.64, 5160.65, 5160.66, 5160.70, 5160.71, 293
5160.75, 5160.99, 5161.01, 5161.03, 5162.02, 294
5162.03, 5162.17, 5163.04, 5164.051, 5165.01, 295
5165.02, 5165.04, 5165.06, 5165.08, 5165.17, 296
5165.18, 5167.01, 5168.03, 5168.04, 5168.08, 297
5168.09, 5168.10, and 5169.99, and to repeal 298
section 5111.012 of the Revised Code; to amend 299
Section 7 of Am. Sub. H.B. 468 of the 126th 300
General Assembly; to create the Department of 301
Health Care Administration; to transfer the 302
Medicaid Program, Children's Health Insurance 303
Program, Children's Buy-In Program, Hospital Care 304
Assurance Program, Disability Medical Assistance 305
Program, Ohio's Best Rx Program, and Residential 306
State Supplement Program to the new department; 307
to require the new department to create a central 308
pharmaceutical purchasing office; and to make an 309
appropriation.310


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That sections 9.231, 9.239, 9.24, 101.39, 311
101.391, 103.144, 109.572, 109.85, 117.10, 119.01, 121.02, 312
121.03, 122.15, 124.30, 124.301, 127.16, 131.23, 145.27, 145.58, 313
149.431, 169.02, 173.14, 173.20, 173.21, 173.26, 173.35, 173.351, 314
173.394, 173.40, 173.401, 173.42, 173.45, 173.47, 173.50, 173.71, 315
173.72, 173.721, 173.722, 173.723, 173.724, 173.73, 173.731, 316
173.732, 173.74, 173.741, 173.742, 173.75, 173.751, 173.752, 317
173.753, 173.76, 173.77, 173.771, 173.772, 173.773, 173.78, 318
173.79, 173.791, 173.80, 173.801, 173.802, 173.803, 173.81, 319
173.811, 173.812, 173.813, 173.814, 173.815, 173.82, 173.83, 320
173.831, 173.832, 173.833, 173.84, 173.85, 173.86, 173.861, 321
173.87, 173.88, 173.89, 173.891, 173.892, 173.90, 173.91, 173.99, 322
317.08, 317.36, 323.01, 329.04, 329.051, 329.06, 329.14, 340.03, 323
340.091, 340.16, 341.192, 505.84, 742.41, 955.201, 1337.11, 324
1347.08, 1731.04, 1739.061, 1751.01, 1751.11, 1751.12, 1751.18, 325
1751.271, 1751.31, 1751.60, 1751.88, 1751.89, 1923.14, 2113.041, 326
2113.06, 2117.061, 2117.25, 2133.01, 2151.3514, 2305.234, 327
2307.65, 2317.02, 2335.39, 2505.02, 2705.02, 2744.05, 2903.33, 328
2913.40, 2913.401, 2921.01, 2921.13, 2945.401, 3101.051, 329
3107.083, 3111.04, 3111.72, 3113.06, 3119.29, 3119.54, 3121.441, 330
3121.898, 3125.36, 3307.20, 3309.22, 3313.714, 3313.715, 331
3323.021, 3599.45, 3701.023, 3701.024, 3701.027, 3701.043, 332
3701.132, 3701.243, 3701.507, 3701.74, 3701.741, 3701.881, 333
3702.30, 3702.31, 3702.51, 3702.522, 3702.591, 3702.62, 3702.74, 334
3702.91, 3712.07, 3712.09, 3721.01, 3721.011, 3721.021, 3721.022, 335
3721.024, 3721.026, 3721.042, 3721.071, 3721.08, 3721.10, 336
3721.12, 3721.121, 3721.13, 3721.15, 3721.16, 3721.17, 3721.19, 337
3721.21, 3721.28, 3721.32, 3721.50, 3721.51, 3721.52, 3721.53, 338
3721.54, 3721.541, 3721.55, 3721.56, 3721.561, 3721.57, 3721.58, 339
3722.10, 3722.16, 3727.02, 3742.30, 3742.51, 3793.07, 3901.3814, 340
3903.14, 3916.06, 3923.122, 3923.27, 3923.281, 3923.33, 3923.38, 341
3923.49, 3923.50, 3923.58, 3923.601, 3923.70, 3923.79, 3923.83, 342
3924.41, 3924.42, 3963.01, 4123.27, 4141.162, 4719.01, 4723.063, 343
4723.17, 4723.63, 4731.151, 4731.65, 4731.71, 4752.02, 4752.09, 344
4753.071, 4755.481, 4758.02, 4758.04, 4761.01, 4761.03, 4769.01, 345
5101.07, 5101.071, 5101.11, 5101.16, 5101.162, 5101.18, 5101.181, 346
5101.182, 5101.184, 5101.21, 5101.212, 5101.214, 5101.216, 347
5101.22, 5101.221, 5101.23, 5101.24, 5101.243, 5101.25, 5101.26, 348
5101.31, 5101.35, 5101.36, 5101.47, 5101.50, 5101.501, 5101.502, 349
5101.503, 5101.51, 5101.511, 5101.512, 5101.513, 5101.514, 350
5101.515, 5101.516, 5101.517, 5101.518, 5101.519, 5101.5110, 351
5101.52, 5101.521, 5101.522, 5101.523, 5101.524, 5101.525, 352
5101.526, 5101.527, 5101.528, 5101.529, 5101.5211, 5101.5212, 353
5101.5213, 5101.5214, 5101.5215, 5101.5216, 5101.571, 5101.572, 354
5101.573, 5101.575, 5101.58, 5101.59, 5101.591, 5101.97, 5103.02, 355
5107.10, 5107.14, 5107.16, 5107.20, 5107.26, 5111.01, 5111.011, 356
5111.013, 5111.014, 5111.015, 5111.016, 5111.018, 5111.019, 357
5111.0110, 5111.0111, 5111.0112, 5111.0113, 5111.0114, 5111.0115, 358
5111.0116, 5111.0117, 5111.0118, 5111.0119, 5111.02, 5111.021, 359
5111.022, 5111.023, 5111.024, 5111.025, 5111.028, 5111.029, 360
5111.03, 5111.031, 5111.032, 5111.033, 5111.034, 5111.04, 361
5111.042, 5111.05, 5111.06, 5111.061, 5111.062, 5111.07, 362
5111.071, 5111.08, 5111.081, 5111.082, 5111.083, 5111.084, 363
5111.09, 5111.091, 5111.10, 5111.102, 5111.11, 5111.111, 364
5111.112, 5111.113, 5111.114, 5111.12, 5111.121, 5111.13, 365
5111.14, 5111.15, 5111.151, 5111.16, 5111.162, 5111.163, 5111.17, 366
5111.171, 5111.172, 5111.173, 5111.174, 5111.175, 5111.176, 367
5111.177, 5111.178, 5111.18, 5111.181, 5111.19, 5111.191, 368
5111.20, 5111.201, 5111.202, 5111.203, 5111.204, 5111.21, 369
5111.211, 5111.22, 5111.221, 5111.222, 5111.23, 5111.231, 370
5111.232, 5111.235, 5111.24, 5111.241, 5111.242, 5111.243, 371
5111.244, 5111.25, 5111.251, 5111.254, 5111.255, 5111.258, 372
5111.26, 5111.261, 5111.263, 5111.264, 5111.265, 5111.266, 373
5111.27, 5111.28, 5111.29, 5111.291, 5111.30, 5111.31, 5111.32, 374
5111.33, 5111.34, 5111.35, 5111.36, 5111.37, 5111.38, 5111.39, 375
5111.41, 5111.411, 5111.42, 5111.43, 5111.44, 5111.45, 5111.46, 376
5111.47, 5111.48, 5111.49, 5111.50, 5111.51, 5111.52, 5111.53, 377
5111.54, 5111.55, 5111.56, 5111.57, 5111.58, 5111.59, 5111.60, 378
5111.61, 5111.62, 5111.63, 5111.65, 5111.651, 5111.66, 5111.67, 379
5111.671, 5111.672, 5111.673, 5111.674, 5111.675, 5111.676, 380
5111.677, 5111.68, 5111.681, 5111.682, 5111.683, 5111.684, 381
5111.685, 5111.686, 5111.687, 5111.688, 5111.70, 5111.701, 382
5111.702, 5111.703, 5111.704, 5111.705, 5111.707, 5111.708, 383
5111.709, 5111.7010, 5111.7011, 5111.71, 5111.711, 5111.712, 384
5111.713, 5111.714, 5111.715, 5111.84, 5111.85, 5111.851, 385
5111.852, 5111.853, 5111.855, 5111.856, 5111.86, 5111.87, 386
5111.871, 5111.872, 5111.873, 5111.874, 5111.875, 5111.876, 387
5111.877, 5111.878, 5111.879, 5111.8710, 5111.89, 5111.891, 388
5111.894, 5111.90, 5111.91, 5111.911, 5111.912, 5111.913, 389
5111.914, 5111.915, 5111.92, 5111.93, 5111.94, 5111.941, 390
5111.942, 5111.943, 5111.97, 5111.971, 5111.98, 5111.99, 5112.01, 391
5112.03, 5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09, 392
5112.10, 5112.11, 5112.17, 5112.18, 5112.19, 5112.21, 5112.30, 393
5112.31, 5112.32, 5112.33, 5112.34, 5112.341, 5112.35, 5112.37, 394
5112.371, 5112.38, 5112.39, 5112.99, 5115.02, 5115.10, 5115.11, 395
5115.12, 5115.13, 5115.14, 5115.20, 5115.22, 5115.23, 5117.10, 396
5119.04, 5119.061, 5119.16, 5119.351, 5119.61, 5120.65, 5120.652, 397
5121.04, 5123.01, 5123.021, 5123.0412, 5123.0417, 5123.171, 398
5123.181, 5123.19, 5123.192, 5123.198, 5123.211, 5123.71, 399
5123.76, 5126.01, 5126.042, 5126.046, 5126.054, 5126.055, 400
5126.0512, 5126.082, 5126.12, 5302.221, 5309.082, 5505.04, 401
5725.18, 5729.03, 5731.39, 5747.01, 5747.122, 5747.18, 5751.081, 402
5815.28, and 5907.04 be amended, sections 173.35 (5160.80), 403
173.351 (5160.81), 173.71 (5169.01), 173.72 (5169.02), 173.721 404
(5169.021), 173.722 (5169.022), 173.723 (5169.023), 173.724 405
(5169.024), 173.73 (5169.03), 173.731 (5169.031), 173.732 406
(5169.032), 173.74 (5169.04), 173.741 (5169.041), 173.742 407
(5169.042), 173.75 (5169.05), 173.751 (5169.051), 173.752 408
(5169.052), 173.753 (5169.053), 173.76 (5169.06), 173.77 409
(5169.07), 173.771 (5169.071), 173.772 (5169.072), 173.773 410
(5169.073), 173.78 (5169.08), 173.79 (5169.09), 173.791 411
(5169.091), 173.80 (5169.10), 173.801 (5169.101), 173.802 412
(5169.102), 173.803 (5169.103), 173.81 (5169.11), 173.811 413
(5169.111), 173.812 (5169.112), 173.813 (5169.113), 173.814 414
(5169.114), 173.815 (5169.115), 173.82 (5169.12), 173.83 415
(5169.13), 173.831 (5169.131), 173.832 (5169.132), 173.833 416
(5169.133), 173.84 (5169.14), 173.85 (5169.15), 173.86 (5169.16), 417
173.861 (5169.161), 173.87 (5169.17), 173.871 (5169.171), 418
173.872 (5169.172), 173.873 (5169.173), 173.874 (5169.174), 419
173.875 (5169.175), 173.876 (5169.176), 173.88 (5169.18), 173.89 420
(5169.19), 173.891 (5169.191), 173.892 (5169.192), 173.90 421
(5169.20), 173.91 (5169.21), 3721.50 (5166.20), 3721.51 422
(5166.21), 3721.52 (5166.22), 3721.53 (5166.23), 3721.54 423
(5166.24), 3721.541 (5166.25), 3721.55 (5166.26), 3721.56 424
(5166.27), 3721.561 (5166.28), 3721.57 (5166.29), 3721.58 425
(5166.30), 5101.31 (5160.67), 5101.50 (5167.05), 5101.501 426
(5167.06), 5101.502 (5167.07), 5101.503 (5167.08), 5101.51 427
(5167.10), 5101.511 (5167.11), 5101.512 (5167.12), 5101.513 428
(5167.13), 5101.514 (5167.14), 5101.515 (5167.15), 5101.516 429
(5167.16), 5101.517 (5167.17), 5101.518 (5167.18), 5101.519 430
(5167.19), 5101.5110 (5167.32), 5101.52 (5167.21), 5101.521 431
(5167.22), 5101.522 (5167.23), 5101.523 (5167.24), 5101.524 432
(5167.25), 5101.525 (5167.26), 5101.526 (5167.27), 5101.527 433
(5167.28), 5101.528 (5167.29), 5101.529 (5167.30), 5101.5211 434
(5167.35), 5101.5212 (5167.36), 5101.5213 (5167.37), 5101.5214 435
(5167.38), 5101.5215 (5167.39), 5101.5216 (5167.40), 5101.571 436
(5160.36), 5101.572 (5160.40), 5101.573 (5160.401), 5101.574 437
(5160.402), 5101.575 (5160.403), 5101.58 (5160.38), 5101.59 438
(5160.37), 5101.591 (5160.41), 5111.01 (5162.01), 5111.011 439
(5162.20), 5111.013 (5162.15), 5111.014 (5162.04), 5111.015 440
(5162.24), 5111.016 (5162.16), 5111.018 (5163.18), 5111.019 441
(5162.05), 5111.0110 (5162.08), 5111.0111 (5162.06), 5111.0112 442
(5162.35), 5111.0113 (5162.07), 5111.0114 (5163.261), 5111.0115 443
(5162.09), 5111.0116 (5162.21), 5111.0117 (5162.22), 5111.0118 444
(5162.23), 5111.0119 (5162.18), 5111.02 (5163.15), 5111.021 445
(5163.16), 5111.022 (5163.08), 5111.023 (5163.20), 5111.024 446
(5163.19), 5111.025 (5163.17), 5111.027 (5163.242), 5111.028 447
(5163.011), 5111.029 (5163.27), 5111.03 (5163.03), 5111.031 448
(5163.031), 5111.032 (5163.032), 5111.033 (5163.033), 5111.034 449
(5163.034), 5111.04 (5163.21), 5111.042 (5163.28), 5111.05 450
(5163.02), 5111.06 (5163.01), 5111.061 (5163.07), 5111.062 451
(5163.09), 5111.07 (5163.25), 5111.071 (5163.251), 5111.08 452
(5163.241), 5111.081 (5163.26), 5111.082 (5163.24), 5111.083 453
(5163.243), 5111.084 (5160.04), 5111.09 (5161.32), 5111.091 454
(5161.33), 5111.10 (5161.30), 5111.101 (5163.12), 5111.102 455
(5161.011), 5111.11 (5162.40), 5111.111 (5162.41), 5111.112 456
(5162.42), 5111.113 (5162.37), 5111.114 (5162.36), 5111.12 457
(5162.45), 5111.121 (5160.39), 5111.13 (5165.30), 5111.14 458
(5163.22), 5111.15 (5162.25), 5111.151 (5162.26), 5111.16 459
(5165.03), 5111.162 (5165.14), 5111.163 (5165.15), 5111.17 460
(5165.05), 5111.171 (5165.07), 5111.172 (5165.09), 5111.173 461
(5165.10), 5111.174 (5165.12), 5111.175 (5165.13), 5111.176 462
(5166.60), 5111.177 (5165.11), 5111.178 (5165.16), 5111.18 463
(5162.43), 5111.181 (5162.30), 5111.19 (5163.23), 5111.191 464
(5163.231), 5111.20 (5164.01), 5111.201 (5164.011), 5111.202 465
(5164.45), 5111.203 (5164.46), 5111.204 (5164.47), 5111.21 466
(5164.02), 5111.211 (5164.14), 5111.22 (5164.03), 5111.221 467
(5164.40), 5111.222 (5164.18), 5111.223 (5164.031), 5111.23 468
(5164.05), 5111.231 (5164.19), 5111.232 (5164.191), 5111.235 469
(5164.06), 5111.24 (5164.20), 5111.241 (5164.07), 5111.242 470
(5164.21), 5111.243 (5164.22), 5111.244 (5164.23), 5111.25 471
(5164.24), 5111.251 (5164.08), 5111.254 (5164.32), 5111.255 472
(5164.12), 5111.257 (5164.27), 5111.258 (5164.34), 5111.26 473
(5164.37), 5111.261 (5164.10), 5111.263 (5164.26), 5111.264 474
(5164.372), 5111.265 (5164.28), 5111.266 (5164.371), 5111.27 475
(5164.38), 5111.28 (5164.39), 5111.29 (5164.41), 5111.291 476
(5164.13), 5111.30 (5164.032), 5111.31 (5164.033), 5111.32 477
(5164.034), 5111.33 (5164.35), 5111.34 (5164.30), 5111.35 478
(5164.50), 5111.36 (5164.51), 5111.37 (5164.52), 5111.38 479
(5164.53), 5111.39 (5164.54), 5111.40 (5164.55), 5111.41 480
(5164.56), 5111.411 (5164.57), 5111.42 (5164.58), 5111.43 481
(5164.59), 5111.44 (5164.60), 5111.45 (5164.61), 5111.46 482
(5164.62), 5111.47 (5164.63), 5111.48 (5164.64), 5111.49 483
(5164.65), 5111.50 (5164.66), 5111.51 (5164.67), 5111.52 484
(5164.68), 5111.53 (5164.69), 5111.54 (5164.70), 5111.55 485
(5164.71), 5111.56 (5164.72), 5111.57 (5164.73), 5111.58 486
(5164.74), 5111.59 (5164.75), 5111.60 (5164.76), 5111.61 487
(5164.77), 5111.62 (5164.78), 5111.63 (5164.79), 5111.65 488
(5164.82), 5111.651 (5164.821), 5111.66 (5164.83), 5111.67 489
(5164.84), 5111.671 (5164.841), 5111.672 (5164.842), 5111.673 490
(5164.843), 5111.674 (5164.844), 5111.675 (5164.845), 5111.676 491
(5164.846), 5111.677 (5164.847), 5111.68 (5164.85), 5111.681 492
(5164.851), 5111.682 (5164.852), 5111.683 (5164.853), 5111.684 493
(5164.854), 5111.685 (5164.855), 5111.686 (5164.856), 5111.687 494
(5164.857), 5111.688 (5164.858), 5111.70 (5162.10), 5111.701 495
(5162.101), 5111.702 (5162.102), 5111.703 (5162.103), 5111.704 496
(5162.104) 5111.705 (5162.105), 5111.706 (5162.106), 5111.707 497
(5162.107), 5111.708 (5162.108), 5111.709 (5162.109), 5111.7010 498
(5162.1010), 5111.7011 (5162.1011), 5111.71 (5163.30), 5111.711 499
(5163.301), 5111.712 (5163.302), 5111.713 (5163.303), 5111.714 500
(5163.304), 5111.715 (5163.305), 5111.84 (5163.501), 5111.85 501
(5163.50), 5111.851 (5163.51), 5111.852 (5163.52), 5111.853 502
(5163.53), 5111.854 (5163.54), 5111.855 (5163.55), 5111.856 503
(5163.56), 5111.86 (5163.60), 5111.87 (5163.65), 5111.871 504
(5163.651), 5111.872 (5163.652), 5111.873 (5163.653), 5111.874 505
(5163.66), 5111.875 (5163.661), 5111.876 (5163.662), 5111.877 506
(5163.663), 5111.878 (5163.664), 5111.879 (5163.665), 5111.8710 507
(5163.666), 5111.89 (5163.68), 5111.891 (5163.681), 5111.892 508
(5163.682), 5111.893 (5163.683), 5111.894 (5163.684), 5111.90 509
(5161.10), 5111.91 (5161.05), 5111.911 (5161.06), 5111.912 510
(5161.07), 5111.913 (5161.08), 5111.914 (5163.06), 5111.915 511
(5161.25), 5111.92 (5161.12), 5111.93 (5161.13), 5111.94 512
(5161.15), 5111.941 (5161.16), 5111.942 (5161.17), 5111.943 513
(5161.18), 5111.97 (5163.73), 5111.971 (5163.69), 5111.98 514
(5161.02), 5111.99 (5164.99), 5112.01 (5166.01), 5112.03 515
(5166.02), 5112.04 (5166.03), 5112.05 (5166.04), 5112.06 516
(5166.05), 5112.07 (5166.06), 5112.08 (5166.07), 5112.09 517
(5166.08), 5112.10 (5166.09), 5112.11 (5166.10), 5112.17 518
(5166.11), 5112.18 (5166.12), 5112.19 (5166.13), 5112.21 519
(5166.14), 5112.30 (5166.40), 5112.31 (5166.41), 5112.32 520
(5166.43), 5112.33 (5166.44), 5112.34 (5166.45), 5112.341 521
(5166.46), 5112.35 (5166.47), 5112.37 (5166.48), 5112.371 522
(5166.481), 5112.38 (5166.49), 5112.39 (5166.50), 5112.99 523
(5166.99), 5115.10 (5168.01), 5115.11 (5168.02), 5115.12 524
(5168.05), 5115.13 (5168.07), 5115.14 (5168.06) be amended for 525
the purpose of adopting a new section number as indicated in 526
parentheses, and that sections 117.54, 117.55, 117.56, 117.57, 527
329.043, 5160.01, 5160.02, 5160.03, 5160.05, 5160.06, 5160.08, 528
5160.10, 5160.101, 5160.12, 5160.13, 5160.15, 5160.151, 529
5160.152, 5160.17, 5160.18, 5160.19, 5160.191, 5160.192, 5160.20, 530
5160.21, 5160.211, 5160.22, 5160.23, 5160.24, 5160.26, 5160.261, 531
5160.262, 5160.28, 5160.29, 5160.30, 5160.32, 5160.34, 5160.341, 532
5160.42, 5160.43, 5160.44, 5160.45, 5160.46, 5160.50, 5160.51, 533
5160.52, 5160.53, 5160.54, 5160.55, 5160.56, 5160.57, 5160.58, 534
5160.59, 5160.60, 5160.61, 5160.62, 5160.63, 5160.64, 5160.65, 535
5160.66, 5160.70, 5160.71, 5160.75, 5160.99, 5161.01, 5161.03, 536
5162.02, 5162.03, 5162.17, 5163.04, 5164.051, 5165.01, 5165.02, 537
5165.04, 5165.06, 5165.08, 5165.17, 5165.18, 5167.01, 5168.03, 538
5168.04, 5168.08, 5168.09, 5168.10, and 5169.99 of the Revised 539
Code be enacted to read as follows:540

       Sec. 9.231. (A)(1) Subject to divisions (A)(2) and (3) of 541
this section, a governmental entity shall not disburse money 542
totaling twenty-five thousand dollars or more to any person for 543
the provision of services for the primary benefit of individuals 544
or the public and not for the primary benefit of a governmental 545
entity or the employees of a governmental entity, unless the 546
contracting authority of the governmental entity first enters into 547
a written contract with the person that is signed by the person or 548
by an officer or agent of the person authorized to legally bind 549
the person and that embodies all of the requirements and 550
conditions set forth in sections 9.23 to 9.236 of the Revised 551
Code. If the disbursement of money occurs over the course of a 552
governmental entity's fiscal year, rather than in a lump sum, the 553
contracting authority of the governmental entity shall enter into 554
the written contract with the person at the point during the 555
governmental entity's fiscal year that at least seventy-five 556
thousand dollars has been disbursed by the governmental entity to 557
the person. Thereafter, the contracting authority of the 558
governmental entity shall enter into the written contract with the 559
person at the beginning of the governmental entity's fiscal year, 560
if, during the immediately preceding fiscal year, the governmental 561
entity disbursed to that person an aggregate amount totaling at 562
least seventy-five thousand dollars.563

       (2) If the money referred to in division (A)(1) of this 564
section is disbursed by or through more than one state agency to 565
the person for the provision of services to the same population, 566
the contracting authorities of those agencies shall determine 567
which one of them will enter into the written contract with the 568
person.569

       (3) The requirements and conditions set forth in divisions 570
(A), (B), (C), and (F) of section 9.232, divisions (A)(1) and (2) 571
and (B) of section 9.234, divisions (A)(2) and (B) of section 572
9.235, and sections 9.233 and 9.236 of the Revised Code do not 573
apply with respect to the following:574

       (a) Contracts to which all of the following apply: 575

       (i) The amount received for the services is a set fee for 576
each time the services are provided, is determined in accordance 577
with a fixed rate per unit of time or per service, or is a 578
capitated rate, and the fee or rate is established by competitive 579
bidding or by a market rate survey of similar services provided in 580
a defined market area. The market rate survey may be one conducted 581
by or on behalf of the governmental entity or an independent 582
survey accepted by the governmental entity as statistically valid 583
and reliable.584

       (ii) The services are provided in accordance with standards 585
established by state or federal law, or by rules or regulations 586
adopted thereunder, for their delivery, which standards are 587
enforced by the federal government, a governmental entity, or an 588
accrediting organization recognized by the federal government or a 589
governmental entity.590

       (iii) Payment for the services is made after the services are 591
delivered and upon submission to the governmental entity of an 592
invoice or other claim for payment as required by any applicable 593
local, state, or federal law or, if no such law applies, by the 594
terms of the contract. 595

       (b) Contracts under which the services are reimbursed through 596
or in a manner consistent with a federal program that meets all of 597
the following requirements:598

       (i) The program calculates the reimbursement rate on the 599
basis of the previous year's experience or in accordance with an 600
alternative method set forth in rules adopted by the Ohio 601
department of job and family services.602

       (ii) The reimbursement rate is derived from a breakdown of 603
direct and indirect costs.604

       (iii) The program's guidelines describe types of expenditures 605
that are allowable and not allowable under the program and 606
delineate which costs are acceptable as direct costs for purposes 607
of calculating the reimbursement rate.608

       (iv) The program includes a uniform cost reporting system 609
with specific audit requirements.610

       (c) Contracts under which the services are reimbursed through 611
or in a manner consistent with a federal program that calculates 612
the reimbursement rate on a fee for service basis in compliance 613
with United States office of management and budget Circular A-87, 614
as revised May 10, 2004. 615

       (d) Contracts for services that are paid pursuant to the 616
earmarking of an appropriation made by the general assembly for 617
that purpose.618

       (B) Division (A) of this section does not apply if the money 619
is disbursed to a person pursuant to a contract with the United 620
States or a governmental entity under any of the following 621
circumstances:622

       (1) The person receives the money directly or indirectly from 623
the United States, and no governmental entity exercises any 624
oversight or control over the use of the money.625

       (2) The person receives the money solely in return for the 626
performance of one or more of the following types of services:627

       (a) Medical, therapeutic, or other health-related services 628
provided by a person if the amount received is a set fee for each 629
time the person provides the services, is determined in accordance 630
with a fixed rate per unit of time, or is a capitated rate, and 631
the fee or rate is reasonable and customary in the person's trade 632
or profession;633

       (b) Medicaid-funded services, including administrative and 634
management services, provided pursuant to a contract or medicaid 635
provider agreement that meets the requirements of the medicaid 636
program established under Chapter 5111. of the Revised Code. 637

       (c) Services, other than administrative or management 638
services or any of the services described in division (B)(2)(a) or 639
(b) of this section, that are commonly purchased by the public at 640
an hourly rate or at a set fee for each time the services are 641
provided, unless the services are performed for the benefit of 642
children, persons who are eligible for the services by reason of 643
advanced age, medical condition, or financial need, or persons who 644
are confined in a detention facility as defined in section 2921.01 645
of the Revised Code, and the services are intended to help promote 646
the health, safety, or welfare of those children or persons;647

       (d) Educational services provided by a school to children 648
eligible to attend that school. For purposes of division (B)(2)(d) 649
of this section, "school" means any school operated by a school 650
district board of education, any community school established 651
under Chapter 3314. of the Revised Code, or any nonpublic school 652
for which the state board of education prescribes minimum 653
education standards under section 3301.07 of the Revised Code.654

       (e) Services provided by a foster home as defined in section 655
5103.02 of the Revised Code;656

       (f) "Routine business services other than administrative or 657
management services," as that term is defined by the attorney 658
general by rule adopted in accordance with Chapter 119. of the 659
Revised Code;660

       (g) Services to protect the environment or promote 661
environmental education that are provided by a nonprofit entity or 662
services to protect the environment that are funded with federal 663
grants or revolving loan funds and administered in accordance with 664
federal law;665

       (h) Services, including administrative and management 666
services, provided under the children's buy-in program established 667
under sections 5101.52115167.35 to 5101.52165167.40 of the 668
Revised Code.669

       (3) The person receives the money solely in return for the 670
performance of services intended to help preserve public health or 671
safety under circumstances requiring immediate action as a result 672
of a natural or man-made emergency.673

       (C) With respect to a nonprofit association, corporation, or 674
organization established for the purpose of providing educational, 675
technical, consulting, training, financial, or other services to 676
its members in exchange for membership dues and other fees, any of 677
the services provided to a member that is a governmental entity 678
shall, for purposes of this section, be considered services "for 679
the primary benefit of a governmental entity or the employees of a 680
governmental entity.681

       Sec. 9.239. (A) There is hereby created the government 682
contracting advisory council. The attorney general and auditor of 683
state shall consult with the council on the performance of their 684
rule-making functions under sections 9.237 and 9.238 of the 685
Revised Code and shall consider any recommendations of the 686
council. The director of job and family services shall annually 687
report to the council the cost methodology of the medicaid-funded 688
services described in division (A)(3)(d) of section 9.231 of the 689
Revised Code. The council shall consist of the following members 690
or their designees:691

       (1) The attorney general;692

       (2) The auditor of state;693

       (3) The director of administrative services;694

       (4) The director of aging;695

       (5) The director of alcohol and drug addiction services;696

       (6) The director of budget and management;697

       (7) The director of development;698

       (8) The director of job and family services;699

       (9) The director of mental health;700

       (10) The director of mental retardation and developmental 701
disabilities;702

       (11) The director of rehabilitation and correction;703

       (12) The administrator of workers' compensation;704

       (13) The executive director of the county commissioners' 705
association of Ohio;706

       (14) The president of the Ohio grantmakers forum;707

       (15) The president of the Ohio chamber of commerce;708

       (16) The president of the Ohio state bar association;709

       (17) The president of the Ohio society of certified public 710
accountants;711

       (18) The executive director of the Ohio association of 712
nonprofit organizations;713

       (19) The president of the Ohio united way;714

       (20) One additional member appointed by the attorney general;715

       (21) One additional member appointed by the auditor of state.716

       (B) If an agency or organization represented on the council 717
ceases to exist in the form it has on the effective date of this 718
sectionSeptember 29, 2005, the successor agency or organization 719
shall be represented in its place. If there is no successor agency 720
or organization, or if it is not clear what agency or organization 721
is the successor, the attorney general shall designate an agency 722
or organization to be represented in place of the agency or 723
organization originally represented on the council.724

       (C) The two members appointed to the council shall serve 725
three-year terms. Original appointments shall be made not later 726
than sixty days after the effective date of this sectionSeptember 727
29, 2005. Vacancies on the council shall be filled in the same 728
manner as the original appointment.729

       (D) The attorney general or the attorney general's designee 730
shall be the chairperson of the council. The council shall meet at 731
least once every two years to review the rules adopted under 732
sections 9.237 and 9.238 of the Revised Code and to make 733
recommendations to the attorney general and auditor of state 734
regarding the adoption, amendment, or repeal of those rules. The 735
council shall also meet at other times as requested by the 736
attorney general or auditor of state.737

       (E) Members of the council shall serve without compensation 738
or reimbursement.739

       (F) The office of the attorney general shall provide 740
necessary staff, facilities, supplies, and services to the 741
council.742

       (G) Sections 101.82 to 101.87 of the Revised Code do not 743
apply to the council.744

       Sec. 9.24. (A) Except as may be allowed under division (F) of 745
this section, no state agency and no political subdivision shall 746
award a contract as described in division (G)(1) of this section 747
for goods, services, or construction, paid for in whole or in part 748
with state funds, to a person against whom a finding for recovery 749
has been issued by the auditor of state on and after January 1, 750
2001, if the finding for recovery is unresolved.751

       A contract is considered to be awarded when it is entered 752
into or executed, irrespective of whether the parties to the 753
contract have exchanged any money.754

        (B) For purposes of this section, a finding for recovery is 755
unresolved unless one of the following criteria applies:756

        (1) The money identified in the finding for recovery is paid 757
in full to the state agency or political subdivision to whom the 758
money was owed;759

        (2) The debtor has entered into a repayment plan that is 760
approved by the attorney general and the state agency or political 761
subdivision to whom the money identified in the finding for 762
recovery is owed. A repayment plan may include a provision 763
permitting a state agency or political subdivision to withhold 764
payment to a debtor for goods, services, or construction provided 765
to or for the state agency or political subdivision pursuant to a 766
contract that is entered into with the debtor after the date the 767
finding for recovery was issued.768

        (3) The attorney general waives a repayment plan described in 769
division (B)(2) of this section for good cause;770

        (4) The debtor and state agency or political subdivision to 771
whom the money identified in the finding for recovery is owed have 772
agreed to a payment plan established through an enforceable 773
settlement agreement.774

        (5) The state agency or political subdivision desiring to 775
enter into a contract with a debtor certifies, and the attorney 776
general concurs, that all of the following are true:777

        (a) Essential services the state agency or political 778
subdivision is seeking to obtain from the debtor cannot be 779
provided by any other person besides the debtor;780

        (b) Awarding a contract to the debtor for the essential 781
services described in division (B)(5)(a) of this section is in the 782
best interest of the state;783

        (c) Good faith efforts have been made to collect the money 784
identified in the finding of recovery.785

       (6) The debtor has commenced an action to contest the finding 786
for recovery and a final determination on the action has not yet 787
been reached.788

        (C) The attorney general shall submit an initial report to 789
the auditor of state, not later than December 1, 2003, indicating 790
the status of collection for all findings for recovery issued by 791
the auditor of state for calendar years 2001, 2002, and 2003. 792
Beginning on January 1, 2004, the attorney general shall submit to 793
the auditor of state, on the first day of every January, April, 794
July, and October, a list of all findings for recovery that have 795
been resolved in accordance with division (B) of this section 796
during the calendar quarter preceding the submission of the list 797
and a description of the means of resolution. The attorney general 798
shall notify the auditor of state when a judgment is issued 799
against an entity described in division (F)(1) of this section.800

       (D) The auditor of state shall maintain a database, 801
accessible to the public, listing persons against whom an 802
unresolved finding for recovery has been issued, and the amount of 803
the money identified in the unresolved finding for recovery. The 804
auditor of state shall have this database operational on or before 805
January 1, 2004. The initial database shall contain the 806
information required under this division for calendar years 2001, 807
2002, and 2003.808

       Beginning January 15, 2004, the auditor of state shall update 809
the database by the fifteenth day of every January, April, July, 810
and October to reflect resolved findings for recovery that are 811
reported to the auditor of state by the attorney general on the 812
first day of the same month pursuant to division (C) of this 813
section.814

        (E) Before awarding a contract as described in division 815
(G)(1) of this section for goods, services, or construction, paid 816
for in whole or in part with state funds, a state agency or 817
political subdivision shall verify that the person to whom the 818
state agency or political subdivision plans to award the contract 819
has no unresolved finding for recovery issued against the person. 820
A state agency or political subdivision shall verify that the 821
person does not appear in the database described in division (D) 822
of this section or shall obtain other proof that the person has no 823
unresolved finding for recovery issued against the person.824

        (F) The prohibition of division (A) of this section and the 825
requirement of division (E) of this section do not apply with 826
respect to the companies, payments, or agreements described in 827
divisions (F)(1) and (2) of this section, or in the circumstance 828
described in division (F)(3) of this section.829

       (1) A bonding company or a company authorized to transact the 830
business of insurance in this state, a self-insurance pool, joint 831
self-insurance pool, risk management program, or joint risk 832
management program, unless a court has entered a final judgment 833
against the company and the company has not yet satisfied the 834
final judgment.835

       (2) To medicaid provider agreements under Chapter 5111. of 836
the Revised Codethe medicaid program, payments or provider 837
agreements under disability assistance medical assistance 838
established under Chapter 5115. of the Revised Code, or payments 839
or provider agreements under the children's buy-in program 840
established under sections 5101.5211 to 5101.5216 of the Revised 841
Code.842

       (3) When federal law dictates that a specified entity provide 843
the goods, services, or construction for which a contract is being 844
awarded, regardless of whether that entity would otherwise be 845
prohibited from entering into the contract pursuant to this 846
section.847

       (G)(1) This section applies only to contracts for goods, 848
services, or construction that satisfy the criteria in either 849
division (G)(1)(a) or (b) of this section. This section may apply 850
to contracts for goods, services, or construction that satisfy the 851
criteria in division (G)(1)(c) of this section, provided that the 852
contracts also satisfy the criteria in either division (G)(1)(a) 853
or (b) of this section.854

       (a) The cost for the goods, services, or construction 855
provided under the contract is estimated to exceed twenty-five 856
thousand dollars.857

       (b) The aggregate cost for the goods, services, or 858
construction provided under multiple contracts entered into by the 859
particular state agency and a single person or the particular 860
political subdivision and a single person within the fiscal year 861
preceding the fiscal year within which a contract is being entered 862
into by that same state agency and the same single person or the 863
same political subdivision and the same single person, exceeded 864
fifty thousand dollars.865

       (c) The contract is a renewal of a contract previously 866
entered into and renewed pursuant to that preceding contract.867

       (2) This section does not apply to employment contracts.868

       (H) As used in this section:869

       (1) "State agency" has the same meaning as in section 9.66 of 870
the Revised Code.871

       (2) "Political subdivision" means a political subdivision as 872
defined in section 9.82 of the Revised Code that has received more 873
than fifty thousand dollars of state money in the current fiscal 874
year or the preceding fiscal year.875

       (3) "Finding for recovery" means a determination issued by 876
the auditor of state, contained in a report the auditor of state 877
gives to the attorney general pursuant to section 117.28 of the 878
Revised Code, that public money has been illegally expended, 879
public money has been collected but not been accounted for, public 880
money is due but has not been collected, or public property has 881
been converted or misappropriated.882

        (4) "Debtor" means a person against whom a finding for 883
recovery has been issued.884

       (5) "Person" means the person named in the finding for 885
recovery.886

       (6) "State money" does not include funds the state receives 887
from another source and passes through to a political 888
subdivision.889

       Sec. 101.39.  (A) There is hereby created the joint890
legislative committee on health care oversight. The committee may891
review or study any matter related to the provision of health care892
services that it considers of significance to the citizens of this893
state, including the availability of health care, the quality of894
health care, the effectiveness and efficiency of managed care895
systems, and the operation of the medical assistancemedicaid896
program established under Chapter 5111. of the Revised Code or 897
other government health programs.898

       The department of health care administration, department of899
job and family services, department of health, department of 900
aging, department of mental health, department of mental 901
retardation and developmental disabilities, department of alcohol 902
and drug addiction services, and other state agencies shall 903
cooperate with the committee in its study and review of health 904
care issues. On request, the departments shall provide the 905
committee with reports and other information sufficient for the 906
committee to fulfill its duties.907

       The committee may issue recommendations as it determines908
appropriate. The recommendations may be made to the general909
assembly, state agencies, private industry, or any other entity.910

       (B) The committee shall consist of the following members of911
the general assembly: the chairperson of the senate's standing912
committee with primary responsibility for health legislation, the913
chairperson of the house of representatives' standing committee914
with primary responsibility for health legislation, four members915
of the house of representatives appointed by the speaker of the916
house of representatives, and four members of the senate appointed917
by the president of the senate. Not more than two members918
appointed by the speaker of the house of representatives and not919
more than two members appointed by the president of the senate may920
be of the same political party. Except in 1995, appointments921
shall be made not later than fifteen days after the commencement922
of the first regular session of each general assembly. The923
chairpersons of the standing committees with primary924
responsibility for health legislation shall serve as925
co-chairpersons of the committee.926

       Each member of the committee shall hold office during the927
general assembly in which the member is appointed and until a928
successor has been appointed, notwithstanding the adjournment sine929
die of the general assembly in which the member was appointed or930
the expiration of the member's term as a member of the general931
assembly. Any vacancies occurring among the members of the932
committee shall be filled in the manner of the original933
appointment.934

       The committee shall meet at least quarterly and at the call935
of the co-chairpersons. The co-chairpersons shall determine the936
time, place, and agenda for each meeting of the committee.937

       The committee has the same powers as other standing or select938
committees of the general assembly. The committee may request939
assistance from the legislative service commission and the940
legislative budget office of the legislative service commission.941

       Sec. 101.391.  (A) There is hereby created the joint942
legislative committee on medicaid technology and reform. The 943
committee may review or study any matter that it considers 944
relevant to the operation of the medicaid program established 945
under Chapter 5111. of the Revised Code, with priority given to 946
the study or review of mechanisms to enhance the program's 947
effectiveness through improved technology systems and program 948
reform.949

       (B) The committee shall consist of five members of the house 950
of representatives appointed by the speaker of the house of 951
representatives and five members of the senate appointed by the 952
president of the senate. Not more than three members appointed by 953
the speaker of the house of representatives and not more than 954
three members appointed by the president of the senate may be of 955
the same political party.956

       Each member of the committee shall hold office during the957
general assembly in which the member is appointed and until a958
successor has been appointed, notwithstanding the adjournment sine959
die of the general assembly in which the member was appointed or960
the expiration of the member's term as a member of the general961
assembly. Any vacancies occurring among the members of the962
committee shall be filled in the manner of the original963
appointment.964

       (C) The committee has the same powers as other standing or 965
select committees of the general assembly. The committee may 966
employ an executive director.967

       Sec. 103.144.  As used in sections 103.144 to 103.146 of the968
Revised Code:969

       (A) "Mandated benefit" means the following, when considered970
in the context of a sickness and accident insurance policy or a971
health insuring corporation policy, contract, or agreement:972

       (1) Any required coverage for a specific medical or973
health-related service, treatment, medication, or practice;974

       (2) Any required coverage for the services of specific health975
care providers;976

       (3) Any requirement that an insurer or health insuring977
corporation offer coverage to specific individuals or groups;978

       (4) Any requirement that an insurer or health insuring979
corporation offer specific medical or health-related services,980
treatments, medications, or practices to existing insureds or981
enrollees;982

       (5) Any required expansion of, or addition to, existing983
coverage;984

       (6) Any mandated reimbursement amount to specific health care985
providers.986

       (B) "Mandated benefit" does not include any required coverage 987
or offer of coverage, any required expansion of, or addition to, 988
existing coverage, or any mandated reimbursement amount to 989
specific providers, as described in division (A) of this section, 990
within the context of any public health benefits arrangement, 991
including but not limited to, the coverage of beneficiaries 992
enrolled in Title XVIII of the "Social Security Act," 49 Stat. 620993
(1935), 42 U.S.C.A. 301, as amendedmedicare program, pursuant to 994
a medicare risk contract or medicare cost contract, or to the995
coverage of beneficiaries enrolled in Title XIX of the "Social996
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,997
known asrecipients of the medical assistance program or medicaid, 998
provided by the Ohio department of job and family services under 999
Chapter 5111. of the Revised Codeprogram.1000

       Sec. 109.572. (A)(1) Upon receipt of a request pursuant to 1001
section 121.08, 3301.32, 3301.541, or 3319.39 of the Revised 1002
Code, a completed form prescribed pursuant to division (C)(1) of 1003
this section, and a set of fingerprint impressions obtained in 1004
the manner described in division (C)(2) of this section, the 1005
superintendent of the bureau of criminal identification and 1006
investigation shall conduct a criminal records check in the 1007
manner described in division (B) of this section to determine 1008
whether any information exists that indicates that the person who 1009
is the subject of the request previously has been convicted of or 1010
pleaded guilty to any of the following:1011

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1012
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1013
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05, 1014
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 1015
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 1016
2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 2919.24, 2919.25, 1017
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05, 1018
2925.06, or 3716.11 of the Revised Code, felonious sexual 1019
penetration in violation of former section 2907.12 of the Revised 1020
Code, a violation of section 2905.04 of the Revised Code as it 1021
existed prior to July 1, 1996, a violation of section 2919.23 of 1022
the Revised Code that would have been a violation of section 1023
2905.04 of the Revised Code as it existed prior to July 1, 1996, 1024
had the violation been committed prior to that date, or a 1025
violation of section 2925.11 of the Revised Code that is not a 1026
minor drug possession offense;1027

       (b) A violation of an existing or former law of this state, 1028
any other state, or the United States that is substantially 1029
equivalent to any of the offenses listed in division (A)(1)(a) of 1030
this section.1031

       (2) On receipt of a request pursuant to section 5123.081 of 1032
the Revised Code with respect to an applicant for employment in 1033
any position with the department of mental retardation and 1034
developmental disabilities, pursuant to section 5126.28 of the 1035
Revised Code with respect to an applicant for employment in any 1036
position with a county board of mental retardation and 1037
developmental disabilities, or pursuant to section 5126.281 of the 1038
Revised Code with respect to an applicant for employment in a 1039
direct services position with an entity contracting with a county 1040
board for employment, a completed form prescribed pursuant to 1041
division (C)(1) of this section, and a set of fingerprint 1042
impressions obtained in the manner described in division (C)(2) of 1043
this section, the superintendent of the bureau of criminal 1044
identification and investigation shall conduct a criminal records 1045
check. The superintendent shall conduct the criminal records check 1046
in the manner described in division (B) of this section to 1047
determine whether any information exists that indicates that the 1048
person who is the subject of the request has been convicted of or 1049
pleaded guilty to any of the following:1050

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1051
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1052
2903.341, 2905.01, 2905.02, 2905.04, 2905.05, 2907.02, 2907.03, 1053
2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 1054
2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 1055
2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 1056
2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 1057
2925.03, or 3716.11 of the Revised Code;1058

       (b) An existing or former municipal ordinance or law of this 1059
state, any other state, or the United States that is substantially 1060
equivalent to any of the offenses listed in division (A)(2)(a) of 1061
this section.1062

       (3) On receipt of a request pursuant to section 173.27, 1063
173.394, 3712.09, 3721.121, or 3722.151 of the Revised Code, a 1064
completed form prescribed pursuant to division (C)(1) of this 1065
section, and a set of fingerprint impressions obtained in the 1066
manner described in division (C)(2) of this section, the 1067
superintendent of the bureau of criminal identification and 1068
investigation shall conduct a criminal records check with respect 1069
to any person who has applied for employment in a position for 1070
which a criminal records check is required by those sections. The 1071
superintendent shall conduct the criminal records check in the 1072
manner described in division (B) of this section to determine 1073
whether any information exists that indicates that the person who 1074
is the subject of the request previously has been convicted of or 1075
pleaded guilty to any of the following:1076

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1077
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1078
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05, 1079
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 1080
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 1081
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 1082
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 1083
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 1084
2925.22, 2925.23, or 3716.11 of the Revised Code;1085

       (b) An existing or former law of this state, any other state, 1086
or the United States that is substantially equivalent to any of 1087
the offenses listed in division (A)(3)(a) of this section.1088

       (4) On receipt of a request pursuant to section 3701.881 of 1089
the Revised Code with respect to an applicant for employment with 1090
a home health agency as a person responsible for the care, 1091
custody, or control of a child, a completed form prescribed 1092
pursuant to division (C)(1) of this section, and a set of 1093
fingerprint impressions obtained in the manner described in 1094
division (C)(2) of this section, the superintendent of the bureau 1095
of criminal identification and investigation shall conduct a 1096
criminal records check. The superintendent shall conduct the 1097
criminal records check in the manner described in division (B) of 1098
this section to determine whether any information exists that 1099
indicates that the person who is the subject of the request 1100
previously has been convicted of or pleaded guilty to any of the 1101
following:1102

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1103
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1104
2905.01, 2905.02, 2905.04, 2905.05, 2907.02, 2907.03, 2907.04, 1105
2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.21, 1106
2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 1107
2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 1108
2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 1109
2925.04, 2925.05, 2925.06, or 3716.11 of the Revised Code or a 1110
violation of section 2925.11 of the Revised Code that is not a 1111
minor drug possession offense;1112

       (b) An existing or former law of this state, any other state, 1113
or the United States that is substantially equivalent to any of 1114
the offenses listed in division (A)(4)(a) of this section.1115

       (5) On receipt of a request pursuant to section 5111.0321116
5163.032, 5111.0335163.033, or 5111.0345163.034 of the Revised 1117
Code, a completed form prescribed pursuant to division (C)(1) of 1118
this section, and a set of fingerprint impressions obtained in 1119
the manner described in division (C)(2) of this section, the 1120
superintendent of the bureau of criminal identification and 1121
investigation shall conduct a criminal records check. The 1122
superintendent shall conduct the criminal records check in the 1123
manner described in division (B) of this section to determine 1124
whether any information exists that indicates that the person 1125
who is the subject of the request previously has been convicted 1126
of, has pleaded guilty to, or has been found eligible for 1127
intervention in lieu of conviction for any of the following:1128

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1129
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 1130
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02, 1131
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 1132
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32, 1133
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 1134
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 1135
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11, 1136
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02, 1137
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04, 1138
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or 1139
3716.11 of the Revised Code, felonious sexual penetration in 1140
violation of former section 2907.12 of the Revised Code, a 1141
violation of section 2905.04 of the Revised Code as it existed 1142
prior to July 1, 1996, a violation of section 2919.23 of the 1143
Revised Code that would have been a violation of section 2905.04 1144
of the Revised Code as it existed prior to July 1, 1996, had the 1145
violation been committed prior to that date;1146

       (b) An existing or former law of this state, any other state, 1147
or the United States that is substantially equivalent to any of 1148
the offenses listed in division (A)(5)(a) of this section.1149

       (6) On receipt of a request pursuant to section 3701.881 of 1150
the Revised Code with respect to an applicant for employment with 1151
a home health agency in a position that involves providing direct 1152
care to an older adult, a completed form prescribed pursuant to 1153
division (C)(1) of this section, and a set of fingerprint 1154
impressions obtained in the manner described in division (C)(2) of 1155
this section, the superintendent of the bureau of criminal 1156
identification and investigation shall conduct a criminal records 1157
check. The superintendent shall conduct the criminal records check 1158
in the manner described in division (B) of this section to 1159
determine whether any information exists that indicates that the 1160
person who is the subject of the request previously has been 1161
convicted of or pleaded guilty to any of the following:1162

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1163
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1164
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05, 1165
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 1166
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 1167
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 1168
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 1169
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 1170
2925.22, 2925.23, or 3716.11 of the Revised Code;1171

       (b) An existing or former law of this state, any other state, 1172
or the United States that is substantially equivalent to any of 1173
the offenses listed in division (A)(6)(a) of this section.1174

       (7) When conducting a criminal records check upon a request 1175
pursuant to section 3319.39 of the Revised Code for an applicant 1176
who is a teacher, in addition to the determination made under 1177
division (A)(1) of this section, the superintendent shall 1178
determine whether any information exists that indicates that the 1179
person who is the subject of the request previously has been 1180
convicted of or pleaded guilty to any offense specified in section 1181
3319.31 of the Revised Code.1182

       (8) On receipt of a request pursuant to section 2151.86 of 1183
the Revised Code, a completed form prescribed pursuant to 1184
division (C)(1) of this section, and a set of fingerprint 1185
impressions obtained in the manner described in division (C)(2) 1186
of this section, the superintendent of the bureau of criminal 1187
identification and investigation shall conduct a criminal records 1188
check in the manner described in division (B) of this section to 1189
determine whether any information exists that indicates that the 1190
person who is the subject of the request previously has been 1191
convicted of or pleaded guilty to any of the following:1192

       (a) A violation of section 959.13, 2903.01, 2903.02, 2903.03, 1193
2903.04, 2903.11, 2903.12, 2903.13, 2903.15, 2903.16, 2903.21, 1194
2903.211, 2903.22, 2903.34, 2905.01, 2905.02, 2905.05, 2907.02, 1195
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 1196
2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 1197
2907.322, 2907.323, 2909.02, 2909.03, 2909.22, 2909.23, 2909.24, 1198
2911.01, 2911.02, 2911.11, 2911.12, 2913.49, 2917.01, 2917.02, 1199
2919.12, 2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 1200
2925.02, 2925.03, 2925.04, 2925.05, 2925.06, 2927.12, or 3716.11 1201
of the Revised Code, a violation of section 2905.04 of the 1202
Revised Code as it existed prior to July 1, 1996, a violation of 1203
section 2919.23 of the Revised Code that would have been a 1204
violation of section 2905.04 of the Revised Code as it existed 1205
prior to July 1, 1996, had the violation been committed prior to 1206
that date, a violation of section 2925.11 of the Revised Code 1207
that is not a minor drug possession offense, two or more OVI or 1208
OVUAC violations committed within the three years immediately 1209
preceding the submission of the application or petition that is 1210
the basis of the request, or felonious sexual penetration in 1211
violation of former section 2907.12 of the Revised Code;1212

       (b) A violation of an existing or former law of this state, 1213
any other state, or the United States that is substantially 1214
equivalent to any of the offenses listed in division (A)(8)(a) of 1215
this section.1216

       (9) Upon receipt of a request pursuant to section 5104.012 1217
or 5104.013 of the Revised Code, a completed form prescribed 1218
pursuant to division (C)(1) of this section, and a set of 1219
fingerprint impressions obtained in the manner described in 1220
division (C)(2) of this section, the superintendent of the bureau 1221
of criminal identification and investigation shall conduct a 1222
criminal records check in the manner described in division (B) of 1223
this section to determine whether any information exists that 1224
indicates that the person who is the subject of the request has 1225
been convicted of or pleaded guilty to any of the following:1226

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1227
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.22, 1228
2903.34, 2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 1229
2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 1230
2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 1231
2911.01, 2911.02, 2911.11, 2911.12, 2913.02, 2913.03, 2913.04, 1232
2913.041, 2913.05, 2913.06, 2913.11, 2913.21, 2913.31, 2913.32, 1233
2913.33, 2913.34, 2913.40, 2913.41, 2913.42, 2913.43, 2913.44, 1234
2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49, 2919.12, 1235
2919.22, 2919.24, 2919.25, 2921.11, 2921.13, 2923.01, 2923.12, 1236
2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05, 2925.06, or 1237
3716.11 of the Revised Code, felonious sexual penetration in 1238
violation of former section 2907.12 of the Revised Code, a 1239
violation of section 2905.04 of the Revised Code as it existed 1240
prior to July 1, 1996, a violation of section 2919.23 of the 1241
Revised Code that would have been a violation of section 2905.04 1242
of the Revised Code as it existed prior to July 1, 1996, had the 1243
violation been committed prior to that date, a violation of 1244
section 2925.11 of the Revised Code that is not a minor drug 1245
possession offense, a violation of section 2923.02 or 2923.03 of 1246
the Revised Code that relates to a crime specified in this 1247
division, or a second violation of section 4511.19 of the 1248
Revised Code within five years of the date of application for 1249
licensure or certification.1250

       (b) A violation of an existing or former law of this state, 1251
any other state, or the United States that is substantially 1252
equivalent to any of the offenses or violations described in 1253
division (A)(9)(a) of this section.1254

       (10) Upon receipt of a request pursuant to section 5153.111 1255
of the Revised Code, a completed form prescribed pursuant to 1256
division (C)(1) of this section, and a set of fingerprint 1257
impressions obtained in the manner described in division (C)(2) of 1258
this section, the superintendent of the bureau of criminal 1259
identification and investigation shall conduct a criminal records 1260
check in the manner described in division (B) of this section to 1261
determine whether any information exists that indicates that the 1262
person who is the subject of the request previously has been 1263
convicted of or pleaded guilty to any of the following:1264

       (a) A violation of section 2903.01, 2903.02, 2903.03, 1265
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 1266
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05, 1267
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 1268
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2909.02, 1269
2909.03, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 1270
2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 1271
2925.04, 2925.05, 2925.06, or 3716.11 of the Revised Code, 1272
felonious sexual penetration in violation of former section 1273
2907.12 of the Revised Code, a violation of section 2905.04 of the 1274
Revised Code as it existed prior to July 1, 1996, a violation of 1275
section 2919.23 of the Revised Code that would have been a 1276
violation of section 2905.04 of the Revised Code as it existed 1277
prior to July 1, 1996, had the violation been committed prior to 1278
that date, or a violation of section 2925.11 of the Revised Code 1279
that is not a minor drug possession offense;1280

       (b) A violation of an existing or former law of this state, 1281
any other state, or the United States that is substantially 1282
equivalent to any of the offenses listed in division (A)(10)(a) of 1283
this section.1284

       (11) On receipt of a request for a criminal records check 1285
from an individual pursuant to section 4749.03 or 4749.06 of the 1286
Revised Code, accompanied by a completed copy of the form 1287
prescribed in division (C)(1) of this section and a set of 1288
fingerprint impressions obtained in a manner described in division 1289
(C)(2) of this section, the superintendent of the bureau of 1290
criminal identification and investigation shall conduct a criminal 1291
records check in the manner described in division (B) of this 1292
section to determine whether any information exists indicating 1293
that the person who is the subject of the request has been 1294
convicted of or pleaded guilty to a felony in this state or in any 1295
other state. If the individual indicates that a firearm will be 1296
carried in the course of business, the superintendent shall 1297
require information from the federal bureau of investigation as 1298
described in division (B)(2) of this section. The superintendent 1299
shall report the findings of the criminal records check and any 1300
information the federal bureau of investigation provides to the 1301
director of public safety.1302

       (12) On receipt of a request pursuant to section 1321.37, 1303
1322.03, 1322.031, or 4763.05 of the Revised Code, a completed 1304
form prescribed pursuant to division (C)(1) of this section, and 1305
a set of fingerprint impressions obtained in the manner described 1306
in division (C)(2) of this section, the superintendent of the 1307
bureau of criminal identification and investigation shall conduct 1308
a criminal records check with respect to any person who has 1309
applied for a license, permit, or certification from the 1310
department of commerce or a division in the department. The 1311
superintendent shall conduct the criminal records check in the 1312
manner described in division (B) of this section to determine 1313
whether any information exists that indicates that the person who 1314
is the subject of the request previously has been convicted of or 1315
pleaded guilty to any of the following: a violation of section 1316
2913.02, 2913.11, 2913.31, 2913.51, or 2925.03 of the Revised 1317
Code; any other criminal offense involving theft, receiving 1318
stolen property, embezzlement, forgery, fraud, passing bad 1319
checks, money laundering, or drug trafficking, or any criminal 1320
offense involving money or securities, as set forth in Chapters 1321
2909., 2911., 2913., 2915., 2921., 2923., and 2925. of the 1322
Revised Code; or any existing or former law of this state, any 1323
other state, or the United States that is substantially 1324
equivalent to those offenses.1325

       (13) On receipt of a request for a criminal records check 1326
from the treasurer of state under section 113.041 of the Revised 1327
Code or from an individual under section 4701.08, 4715.101, 1328
4717.061, 4725.121, 4725.501, 4729.071, 4730.101, 4730.14, 1329
4730.28, 4731.081, 4731.15, 4731.171, 4731.222, 4731.281, 1330
4731.296, 4731.531, 4732.091, 4734.202, 4740.061, 4741.10, 1331
4755.70, 4757.101, 4759.061, 4760.032, 4760.06, 4761.051, 1332
4762.031, 4762.06, or 4779.091 of the Revised Code, accompanied 1333
by a completed form prescribed under division (C)(1) of this 1334
section and a set of fingerprint impressions obtained in the 1335
manner described in division (C)(2) of this section, the 1336
superintendent of the bureau of criminal identification and 1337
investigation shall conduct a criminal records check in the 1338
manner described in division (B) of this section to determine 1339
whether any information exists that indicates that the person who 1340
is the subject of the request has been convicted of or pleaded 1341
guilty to any criminal offense in this state or any other state. 1342
The superintendent shall send the results of a check requested 1343
under section 113.041 of the Revised Code to the treasurer of 1344
state and shall send the results of a check requested under any of 1345
the other listed sections to the licensing board specified by the 1346
individual in the request.1347

       (14) On receipt of a request pursuant to section 1121.23, 1348
1155.03, 1163.05, 1315.141, 1733.47, or 1761.26 of the Revised 1349
Code, a completed form prescribed pursuant to division (C)(1) of 1350
this section, and a set of fingerprint impressions obtained in the 1351
manner described in division (C)(2) of this section, the 1352
superintendent of the bureau of criminal identification and 1353
investigation shall conduct a criminal records check in the manner 1354
described in division (B) of this section to determine whether any 1355
information exists that indicates that the person who is the 1356
subject of the request previously has been convicted of or pleaded 1357
guilty to any criminal offense under any existing or former law of 1358
this state, any other state, or the United States.1359

       (15) Not later than thirty days after the date the 1360
superintendent receives a request of a type described in division 1361
(A)(1), (2), (3), (4), (5), (6), (7), (8), (9), (10), (11), 1362
(12), or (14) of this section, the completed form, and the 1363
fingerprint impressions, the superintendent shall send the 1364
person, board, or entity that made the request any information, 1365
other than information the dissemination of which is prohibited 1366
by federal law, the superintendent determines exists with respect 1367
to the person who is the subject of the request that indicates 1368
that the person previously has been convicted of or pleaded 1369
guilty to any offense listed or described in division (A)(1), 1370
(2), (3), (4), (5), (6), (7), (8), (9), (10), (11), (12), or 1371
(14) of this section, as appropriate. The superintendent shall 1372
send the person, board, or entity that made the request a copy of 1373
the list of offenses specified in division (A)(1), (2), (3), (4), 1374
(5), (6), (7), (8), (9), (10), (11), (12), or (14) of this 1375
section, as appropriate. If the request was made under section 1376
3701.881 of the Revised Code with regard to an applicant who may 1377
be both responsible for the care, custody, or control of a child 1378
and involved in providing direct care to an older adult, the 1379
superintendent shall provide a list of the offenses specified in 1380
divisions (A)(4) and (6) of this section.1381

       Not later than thirty days after the superintendent receives 1382
a request for a criminal records check pursuant to section 113.041 1383
of the Revised Code, the completed form, and the fingerprint 1384
impressions, the superintendent shall send the treasurer of state 1385
any information, other than information the dissemination of which 1386
is prohibited by federal law, the superintendent determines exist 1387
with respect to the person who is the subject of the request that 1388
indicates that the person previously has been convicted of or 1389
pleaded guilty to any criminal offense in this state or any other 1390
state.1391

       (B) The superintendent shall conduct any criminal records 1392
check requested under section 113.041, 121.08, 173.27, 173.394, 1393
1121.23, 1155.03, 1163.05, 1315.141, 1322.03, 1322.031, 1733.47, 1394
1761.26, 2151.86, 3301.32, 3301.541, 3319.39, 3701.881, 3712.09, 1395
3721.121, 3722.151, 4701.08, 4715.101, 4717.061, 4725.121, 1396
4725.501, 4729.071, 4730.101, 4730.14, 4730.28, 4731.081, 1397
4731.15, 4731.171, 4731.222, 4731.281, 4731.296, 4731.531, 1398
4732.091, 4734.202, 4740.061, 4741.10, 4749.03, 4749.06, 1399
4755.70, 4757.101, 4759.061, 4760.032, 4760.06, 4761.051, 1400
4762.031, 4762.06, 4763.05, 4779.091, 5104.012, 5104.013, 1401
5111.0325163.032, 5111.0335163.033, 5111.0345163.034, 5123.081, 1402
5126.28, 5126.281, or 5153.111 of the Revised Code as follows:1403

       (1) The superintendent shall review or cause to be reviewed 1404
any relevant information gathered and compiled by the bureau under 1405
division (A) of section 109.57 of the Revised Code that relates to 1406
the person who is the subject of the request, including, if the 1407
criminal records check was requested under section 113.041, 1408
121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05, 1315.141, 1409
1321.37, 1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32, 1410
3301.541, 3319.39, 3701.881, 3712.09, 3721.121, 3722.151, 1411
4749.03, 4749.06, 4763.05, 5104.012, 5104.013, 5111.0325163.032, 1412
5111.0335163.033, 5111.0345163.034, 5123.081, 5126.28, 1413
5126.281, or 5153.111 of the Revised Code, any relevant 1414
information contained in records that have been sealed under 1415
section 2953.32 of the Revised Code;1416

       (2) If the request received by the superintendent asks for 1417
information from the federal bureau of investigation, the 1418
superintendent shall request from the federal bureau of 1419
investigation any information it has with respect to the person 1420
who is the subject of the request, including fingerprint-based 1421
checks of national crime information databases as described in 42 1422
U.S.C. 671 if the request is made pursuant to section 2151.86, 1423
5104.012, or 5104.013 of the Revised Code or if any other Revised 1424
Code section requires fingerprint-based checks of that nature, and 1425
shall review or cause to be reviewed any information the 1426
superintendent receives from that bureau.1427

        (3) The superintendent or the superintendent's designee may 1428
request criminal history records from other states or the federal 1429
government pursuant to the national crime prevention and privacy 1430
compact set forth in section 109.571 of the Revised Code.1431

       (C)(1) The superintendent shall prescribe a form to obtain 1432
the information necessary to conduct a criminal records check from 1433
any person for whom a criminal records check is requested under 1434
section 113.041 of the Revised Code or required by section 1435
121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05, 1315.141, 1436
1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32, 3301.541, 1437
3319.39, 3701.881, 3712.09, 3721.121, 3722.151, 4701.08, 1438
4715.101, 4717.061, 4725.121, 4725.501, 4729.071, 4730.101, 1439
4730.14, 4730.28, 4731.081, 4731.15, 4731.171, 4731.222, 1440
4731.281, 4731.296, 4731.531, 4732.091, 4734.202, 4740.061, 1441
4741.10, 4749.03, 4749.06, 4755.70, 4757.101, 4759.061, 4760.032, 1442
4760.06, 4761.051, 4762.031, 4762.06, 4763.05, 4779.091, 1443
5104.012, 5104.013, 5111.0325163.032, 5111.0335163.033, 1444
5111.0345163.034, 5123.081, 5126.28, 5126.281, or 5153.111 of 1445
the Revised Code. The form that the superintendent prescribes 1446
pursuant to this division may be in a tangible format, in an 1447
electronic format, or in both tangible and electronic formats.1448

       (2) The superintendent shall prescribe standard impression 1449
sheets to obtain the fingerprint impressions of any person for 1450
whom a criminal records check is requested under section 113.041 1451
of the Revised Code or required by section 121.08, 173.27, 1452
173.394, 1121.23, 1155.03, 1163.05, 1315.141, 1322.03, 1322.031, 1453
1733.47, 1761.26, 2151.86, 3301.32, 3301.541, 3319.39, 3701.881, 1454
3712.09, 3721.121, 3722.151, 4701.08, 4715.101, 4717.061, 1455
4725.121, 4725.501, 4729.071, 4730.101, 4730.14, 4730.28, 1456
4731.081, 4731.15, 4731.171, 4731.222, 4731.281, 4731.296, 1457
4731.531, 4732.091, 4734.202, 4740.061, 4741.10, 4749.03, 1458
4749.06, 4755.70, 4757.101, 4759.061, 4760.032, 4760.06, 1459
4761.051, 4762.031, 4762.06, 4763.05, 4779.091, 5104.012, 1460
5104.013, 5111.0325163.032, 5111.0335163.033, 5111.0341461
5163.034, 5123.081, 5126.28, 5126.281, or 5153.111 of the 1462
Revised Code. Any person for whom a records check is requested 1463
under or required by any of those sections shall obtain the 1464
fingerprint impressions at a county sheriff's office, municipal 1465
police department, or any other entity with the ability to make 1466
fingerprint impressions on the standard impression sheets 1467
prescribed by the superintendent. The office, department, or 1468
entity may charge the person a reasonable fee for making the 1469
impressions. The standard impression sheets the superintendent 1470
prescribes pursuant to this division may be in a tangible format, 1471
in an electronic format, or in both tangible and electronic 1472
formats.1473

       (3) Subject to division (D) of this section, the 1474
superintendent shall prescribe and charge a reasonable fee for 1475
providing a criminal records check requested under section 1476
113.041, 121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05, 1477
1315.141, 1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32, 1478
3301.541, 3319.39, 3701.881, 3712.09, 3721.121, 3722.151, 1479
4701.08, 4715.101, 4717.061, 4725.121, 4725.501, 4729.071, 1480
4730.101, 4730.14, 4730.28, 4731.081, 4731.15, 4731.171, 1481
4731.222, 4731.281, 4731.296, 4731.531, 4732.091, 4734.202, 1482
4740.061, 4741.10, 4749.03, 4749.06, 4755.70, 4757.101, 1483
4759.061, 4760.032, 4760.06, 4761.051, 4762.031, 4762.06, 1484
4763.05, 4779.091, 5104.012, 5104.013, 5111.0325163.032, 1485
5111.0335163.033, 5111.0345163.034, 5123.081, 5126.28, 1486
5126.281, or 5153.111 of the Revised Code. The person making a 1487
criminal records request under any of those sections shall pay 1488
the fee prescribed pursuant to this division. A person making 1489
a request under section 3701.881 of the Revised Code for a 1490
criminal records check for an applicant who may be both 1491
responsible for the care, custody, or control of a child and 1492
involved in providing direct care to an older adult shall pay 1493
one fee for the request. In the case of a request under section 1494
1121.23, 1155.03, 1163.05, 1315.141, 1733.47, 1761.26, or 1495
5111.0325163.032 of the Revised Code, the fee shall be paid in 1496
the manner specified in that section.1497

       (4) The superintendent of the bureau of criminal 1498
identification and investigation may prescribe methods of 1499
forwarding fingerprint impressions and information necessary to 1500
conduct a criminal records check, which methods shall include, but 1501
not be limited to, an electronic method.1502

       (D) A determination whether any information exists that 1503
indicates that a person previously has been convicted of or 1504
pleaded guilty to any offense listed or described in division 1505
(A)(1)(a) or (b), (A)(2)(a) or (b), (A)(3)(a) or (b), (A)(4)(a) or 1506
(b), (A)(5)(a) or (b), (A)(6)(a) or (b), (A)(7), (A)(8)(a) or 1507
(b), (A)(9)(a) or (b), (A)(10)(a) or (b), (A)(12), or (A)(14) of 1508
this section, or that indicates that a person previously has 1509
been convicted of or pleaded guilty to any criminal offense in 1510
this state or any other state regarding a criminal records check 1511
of a type described in division (A)(13) of this section, and 1512
that is made by the superintendent with respect to information 1513
considered in a criminal records check in accordance with this 1514
section is valid for the person who is the subject of the 1515
criminal records check for a period of one year from the date 1516
upon which the superintendent makes the determination. During the 1517
period in which the determination in regard to a person is valid, 1518
if another request under this section is made for a criminal 1519
records check for that person, the superintendent shall provide 1520
the information that is the basis for the superintendent's 1521
initial determination at a lower fee than the fee prescribed for 1522
the initial criminal records check.1523

       (E) As used in this section:1524

       (1) "Criminal records check" means any criminal records check 1525
conducted by the superintendent of the bureau of criminal 1526
identification and investigation in accordance with division (B) 1527
of this section.1528

       (2) "Minor drug possession offense" has the same meaning as 1529
in section 2925.01 of the Revised Code.1530

       (3) "Older adult" means a person age sixty or older.1531

       (4) "OVI or OVUAC violation" means a violation of section 1532
4511.19 of the Revised Code or a violation of an existing or 1533
former law of this state, any other state, or the United States 1534
that is substantially equivalent to section 4511.19 of the Revised 1535
Code.1536

       Sec. 109.85.  (A) Upon the written request of the governor,1537
the general assembly, the auditor of state, the director of job1538
and family serviceshealth care administration, the director of1539
health, or the director of budget and management, or upon the 1540
attorney general's becoming aware of criminal or improper activity 1541
related to Chapter 3721. and the medical assistancemedicaid1542
program established under section 5111.01 of the Revised Code, the 1543
attorney general shall investigate any criminal or civil violation 1544
of law related to Chapter 3721. of the Revised Code or the medical 1545
assistancemedicaid program.1546

       (B) When it appears to the attorney general, as a result of1547
an investigation under division (A) of this section, that there is1548
cause to prosecute for the commission of a crime or to pursue a1549
civil remedy, the attorney general may refer the evidence to the1550
prosecuting attorney having jurisdiction of the matter, or to a1551
regular grand jury drawn and impaneled pursuant to sections1552
2939.01 to 2939.24 of the Revised Code, or to a special grand jury1553
drawn and impaneled pursuant to section 2939.17 of the Revised1554
Code, or the attorney general may initiate and prosecute any1555
necessary criminal or civil actions in any court or tribunal of1556
competent jurisdiction in this state. When proceeding under this1557
section, the attorney general, and any assistant or special1558
counsel designated by the attorney general for that purpose, have1559
all rights, privileges, and powers of prosecuting attorneys. The1560
attorney general shall have exclusive supervision and control of1561
all investigations and prosecutions initiated by the attorney1562
general under this section. The forfeiture provisions of Chapter 1563
2981. of the Revised Code apply in relation to any such criminal 1564
action initiated and prosecuted by the attorney general.1565

       (C) Nothing in this section shall prevent a county1566
prosecuting attorney from investigating and prosecuting criminal1567
activity related to Chapter 3721. of the Revised Code and the1568
medical assistancemedicaid program established under section 1569
5111.01 of the Revised Code. The forfeiture provisions of Chapter 1570
2981. of the Revised Code apply in relation to any prosecution of 1571
criminal activity related to the medical assistancemedicaid1572
program undertaken by the prosecuting attorney.1573

       Sec. 117.10.  The auditor of state shall audit all public 1574
offices as provided in this chapter. The auditor of state also may 1575
audit the accounts of private institutions, associations, boards, 1576
and corporations receiving public money for their use and may 1577
require of them annual reports in such form as the auditor of 1578
state prescribes.1579

       If the auditor of state performs or contracts for the 1580
performance of an audit, including a special audit, of the public 1581
employees retirement system, school employees retirement system, 1582
state teachers retirement system, state highway patrol retirement 1583
system, or Ohio police and fire pension fund, the auditor of state 1584
shall make a timely report of the results of the audit to the Ohio 1585
retirement study council.1586

       The auditor of state may audit the accounts of any provider 1587
as defined in section 5111.065163.01 of the Revised Code.1588

       If a public office has been audited by an agency of the 1589
United States government, the auditor of state may, if satisfied 1590
that the federal audit has been conducted according to principles 1591
and procedures not contrary to those of the auditor of state, use 1592
and adopt the federal audit and report in lieu of an audit by the 1593
auditor of state's own office.1594

       Within thirty days after the creation or dissolution or the 1595
winding up of the affairs of any public office, that public office 1596
shall notify the auditor of state in writing that this action has 1597
occurred.1598

       Sec. 117.54.  The auditor of state may enter into agreements 1599
with the director of health care administration, director of job 1600
and family services, and comparable officers of other states for 1601
the exchange of names, current or most recent addresses, and 1602
social security numbers of medicaid recipients and participants 1603
and recipients of Title IV-A programs as defined in section 1604
5101.80 of the Revised Code.1605

       Sec. 117.55.  The auditor of state shall retain, for not less 1606
than two years, at least one copy of all materials containing 1607
information received under sections 117.54, 117.56, 145.27, 1608
742.41, 3307.21, 3309.22, 4123.27, 5101.181, 5101.182, 5160.43, 1609
5160.44, and 5505.04 of the Revised Code. The auditor of state 1610
shall review the information to determine whether overpayments 1611
were made to participants and recipients of public assistance 1612
under Chapters 5107., 5108., and 5115. of the Revised Code and 1613
whether benefits were incorrectly paid on behalf of medicaid 1614
recipients and disability medical assistance recipients. The 1615
auditor of state shall initiate action leading to prosecution, 1616
where warranted, of participants and recipients who received 1617
overpayments or had benefits incorrectly paid on their behalf by 1618
forwarding the name of each such participant or recipient, 1619
together with other pertinent information, to the following:1620

       (A) The attorney general;1621

       (B) The director of job and family services or director of 1622
health care administration, as appropriate;1623

       (C) In the case of public assistance under Chapters 5107., 1624
5108., and 5115. of the Revised Code, the district director of job 1625
and family services of the district through which the public 1626
assistance was received;1627

       (D) The county director of job and family services and county 1628
prosecutor of the county through which the public assistance, 1629
medicaid, or disability medical assistance was received.1630

       Sec. 117.56.  The auditor of state and the attorney general 1631
and persons acting at their direction may examine any records, 1632
whether in computer or printed format, in the possession of the 1633
department of health care administration, the department of job 1634
and family services, or a county department of job and family 1635
services. The auditor of state and attorney general shall provide 1636
safeguards that restrict access to the records to purposes 1637
directly connected with an audit or investigation, prosecution, or 1638
criminal or civil proceeding conducted in connection with the 1639
administration of the medicaid program, the disability medical 1640
assistance program, or a public assistance program under Chapter 1641
5107., 5108., or 5115. of the Revised Code. Persons acting under 1642
this section shall comply with the rules of the director of job 1643
and family services restricting the disclosure of information 1644
regarding participants and recipients of public assistance and 1645
rules of the director of health care administration restricting 1646
the disclosure of information regarding medicaid and disability 1647
medical assistance recipients. A person determined to have failed 1648
to comply with these rules shall thereafter be disqualified from 1649
acting as an agent or employee or in any other capacity under 1650
appointment or employment of any state board, commission, or 1651
agency.1652

       Sec. 117.57. The auditor of state is responsible for the 1653
costs incurred by the auditor of state in carrying out the auditor 1654
of state's duties under sections 117.55 and 117.56 of the Revised 1655
Code.1656

       Sec. 119.01.  As used in sections 119.01 to 119.13 of the1657
Revised Code:1658

       (A)(1) "Agency" means, except as limited by this division,1659
any official, board, or commission having authority to promulgate1660
rules or make adjudications in the civil service commission, the1661
division of liquor control, the department of taxation, the1662
industrial commission, the bureau of workers' compensation, the1663
functions of any administrative or executive officer, department,1664
division, bureau, board, or commission of the government of the1665
state specifically made subject to sections 119.01 to 119.13 of1666
the Revised Code, and the licensing functions of any1667
administrative or executive officer, department, division, bureau,1668
board, or commission of the government of the state having the1669
authority or responsibility of issuing, suspending, revoking, or1670
canceling licenses.1671

       Except as otherwise provided in division (I) of this section,1672
sections 119.01 to 119.13 of the Revised Code do not apply to the1673
public utilities commission. Sections 119.01 to 119.13 of the1674
Revised Code do not apply to the utility radiological safety1675
board; to the controlling board; to actions of the superintendent1676
of financial institutions and the superintendent of insurance in1677
the taking possession of, and rehabilitation or liquidation of,1678
the business and property of banks, savings and loan associations,1679
savings banks, credit unions, insurance companies, associations,1680
reciprocal fraternal benefit societies, and bond investment1681
companies; to any action taken by the division of securities under1682
section 1707.201 of the Revised Code; or to any action that may be1683
taken by the superintendent of financial institutions under1684
section 1113.03, 1121.06, 1121.10, 1125.09, 1125.12, 1125.18, 1685
1157.01, 1157.02, 1157.10, 1165.01, 1165.02, 1165.10, 1349.33, 1686
1733.35, 1733.361, 1733.37, or 1761.03 of the Revised Code.1687

       Sections 119.01 to 119.13 of the Revised Code do not apply to1688
actions of the industrial commission or the bureau of workers'1689
compensation under sections 4123.01 to 4123.94 of the Revised Code1690
with respect to all matters of adjudication, or to the actions of1691
the industrial commission, bureau of workers' compensation board 1692
of directors, and bureau of workers' compensation under division 1693
(D) of section 4121.32, sections 4123.29, 4123.34, 4123.341, 1694
4123.342, 4123.40, 4123.411, 4123.44, 4123.442, 4127.07, 1695
divisions (B), (C), and (E) of section 4131.04, and divisions (B), 1696
(C), and (E) of section 4131.14 of the Revised Code with respect 1697
to all matters concerning the establishment of premium, 1698
contribution, and assessment rates.1699

       (2) "Agency" also means any official or work unit having1700
authority to promulgate rules or make adjudications in the1701
department of job and family services, but only with respect to1702
both of the following:1703

       (a) The adoption, amendment, or rescission of rules that1704
section 5101.09 of the Revised Code requires be adopted in1705
accordance with this chapter;1706

       (b) The issuance, suspension, revocation, or cancellation of1707
licenses.1708

       (B) "License" means any license, permit, certificate,1709
commission, or charter issued by any agency. "License" does not1710
include any arrangement whereby a person, institution, or entity1711
furnishes medicaid services under a provider agreement with the1712
department of job and family services pursuant to Title XIX of the1713
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as1714
amendedhealth care administration.1715

       (C) "Rule" means any rule, regulation, or standard, having a1716
general and uniform operation, adopted, promulgated, and enforced1717
by any agency under the authority of the laws governing such1718
agency, and includes any appendix to a rule. "Rule" does not1719
include any internal management rule of an agency unless the1720
internal management rule affects private rights and does not1721
include any guideline adopted pursuant to section 3301.0714 of the1722
Revised Code.1723

       (D) "Adjudication" means the determination by the highest or1724
ultimate authority of an agency of the rights, duties, privileges,1725
benefits, or legal relationships of a specified person, but does1726
not include the issuance of a license in response to an1727
application with respect to which no question is raised, nor other1728
acts of a ministerial nature.1729

       (E) "Hearing" means a public hearing by any agency in1730
compliance with procedural safeguards afforded by sections 119.011731
to 119.13 of the Revised Code.1732

       (F) "Person" means a person, firm, corporation, association,1733
or partnership.1734

       (G) "Party" means the person whose interests are the subject1735
of an adjudication by an agency.1736

       (H) "Appeal" means the procedure by which a person, aggrieved 1737
by a finding, decision, order, or adjudication of any agency, 1738
invokes the jurisdiction of a court.1739

       (I) "Rule-making agency" means any board, commission,1740
department, division, or bureau of the government of the state1741
that is required to file proposed rules, amendments, or1742
rescissions under division (D) of section 111.15 of the Revised1743
Code and any agency that is required to file proposed rules,1744
amendments, or rescissions under divisions (B) and (H) of section1745
119.03 of the Revised Code. "Rule-making agency" includes the1746
public utilities commission. "Rule-making agency" does not include 1747
any state-supported college or university.1748

       (J) "Substantive revision" means any addition to, elimination 1749
from, or other change in a rule, an amendment of a rule, or a 1750
rescission of a rule, whether of a substantive or procedural 1751
nature, that changes any of the following:1752

       (1) That which the rule, amendment, or rescission permits,1753
authorizes, regulates, requires, prohibits, penalizes, rewards, or1754
otherwise affects;1755

       (2) The scope or application of the rule, amendment, or1756
rescission.1757

       (K) "Internal management rule" means any rule, regulation, or 1758
standard governing the day-to-day staff procedures and operations 1759
within an agency.1760

       Sec. 121.02.  The following administrative departments and 1761
their respective directors are hereby created: 1762

       (A) The office of budget and management, which shall be 1763
administered by the director of budget and management; 1764

       (B) The department of commerce, which shall be administered 1765
by the director of commerce; 1766

       (C) The department of administrative services, which shall be 1767
administered by the director of administrative services; 1768

       (D) The department of transportation, which shall be 1769
administered by the director of transportation; 1770

       (E) The department of agriculture, which shall be 1771
administered by the director of agriculture; 1772

       (F) The department of natural resources, which shall be 1773
administered by the director of natural resources; 1774

       (G) The department of health, which shall be administered by 1775
the director of health; 1776

       (H) The department of job and family services, which shall 1777
be administered by the director of job and family services; 1778

       (I) Until July 1, 1997, the department of liquor control, 1779
which shall be administered by the director of liquor control; 1780

       (J) The department of public safety, which shall be 1781
administered by the director of public safety; 1782

       (K) The department of mental health, which shall be 1783
administered by the director of mental health; 1784

       (L) The department of mental retardation and developmental 1785
disabilities, which shall be administered by the director of 1786
mental retardation and developmental disabilities; 1787

       (M) The department of insurance, which shall be administered 1788
by the superintendent of insurance as director thereof; 1789

       (N) The department of development, which shall be 1790
administered by the director of development; 1791

       (O) The department of youth services, which shall be 1792
administered by the director of youth services; 1793

       (P) The department of rehabilitation and correction, which 1794
shall be administered by the director of rehabilitation and 1795
correction; 1796

       (Q) The environmental protection agency, which shall be 1797
administered by the director of environmental protection; 1798

       (R) The department of aging, which shall be administered by 1799
the director of aging; 1800

       (S) The department of alcohol and drug addiction services, 1801
which shall be administered by the director of alcohol and drug 1802
addiction services; 1803

       (T) The department of veterans services, which shall be 1804
administered by the director of veterans services;1805

       (U) The department of health care administration, which shall 1806
be administered by the director of health care administration. 1807

       The director of each department shall exercise the powers and 1808
perform the duties vested by law in such department. 1809

       Sec. 121.03.  The following administrative department heads 1810
shall be appointed by the governor, with the advice and consent of 1811
the senate, and shall hold their offices during the term of the 1812
appointing governor, and are subject to removal at the pleasure of 1813
the governor. 1814

       (A) The director of budget and management; 1815

       (B) The director of commerce; 1816

       (C) The director of transportation; 1817

       (D) The director of agriculture; 1818

       (E) The director of job and family services; 1819

       (F) Until July 1, 1997, the director of liquor control; 1820

       (G) The director of public safety; 1821

       (H) The superintendent of insurance; 1822

       (I) The director of development; 1823

       (J) The tax commissioner; 1824

       (K) The director of administrative services; 1825

       (L) The director of natural resources; 1826

       (M) The director of mental health; 1827

       (N) The director of mental retardation and developmental 1828
disabilities; 1829

       (O) The director of health; 1830

       (P) The director of youth services; 1831

       (Q) The director of rehabilitation and correction; 1832

       (R) The director of environmental protection; 1833

       (S) The director of aging; 1834

       (T) The director of alcohol and drug addiction services; 1835

       (U) The administrator of workers' compensation who meets the 1836
qualifications required under division (A) of section 4121.121 of 1837
the Revised Code; 1838

       (V) The director of veterans services who meets the 1839
qualifications required under section 5902.01 of the Revised Code;1840

       (W) The director of health care administration. 1841

       Sec. 122.15.  As used in sections 122.15 to 122.154 of the1842
Revised Code:1843

       (A) "Edison center" means a cooperative research and1844
development facility that receives funding through the Thomas Alva1845
Edison grant program under division (C) of section 122.33 of the1846
Revised Code.1847

       (B) "Ohio entity" means any corporation, limited liability1848
company, or unincorporated business organization, including a1849
general or limited partnership, that has its principal place of1850
business located in this state and has at least fifty per cent of1851
its gross assets and fifty per cent of its employees located in1852
this state. If a corporation, limited liability company, or1853
unincorporated business organization is a member of an affiliated1854
group, the gross assets and the number of employees of all of the1855
members of that affiliated group, wherever those assets and1856
employees are located, shall be included for the purpose of1857
determining the percentage of the corporation's, company's, or1858
organization's gross assets and employees that are located in this1859
state.1860

       (C) "Qualified trade or business" means any trade or business1861
that primarily involves research and development, technology1862
transfer, bio-technology, information technology, or the1863
application of new technology developed through research and1864
development or acquired through technology transfer. "Qualified1865
trade or business" does not include any of the following:1866

       (1) Any trade or business involving the performance of1867
services in the field of law, engineering, architecture,1868
accounting, actuarial science, performing arts, consulting,1869
athletics, financial services, or brokerage services, or any trade1870
or business where the principal asset of the trade or business is1871
the reputation or skill of one or more of its employees;1872

       (2) Any banking, insurance, financing, leasing, rental,1873
investing, or similar business;1874

       (3) Any farming business, including the business of raising1875
or harvesting trees;1876

       (4) Any business involving the production or extraction of1877
products of a character with respect to which a deduction is1878
allowable under section 611, 613, or 613A of the "Internal Revenue1879
Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 611, 613, or 613A;1880

       (5) Any business of operating a hotel, motel, restaurant, or1881
similar business;1882

       (6) Any trade or business involving a hospital, a private1883
office of a licensed health care professional, a group practice of1884
licensed health care professionals, or a nursing home. As used in1885
division (C)(6) of this section:1886

       (a) "Nursing home" has the same meaning as in section 3721.501887
5166.20 of the Revised Code.1888

       (b) "Hospital" has the same meaning as in section 3727.01 of1889
the Revised Code.1890

       (D) "Information technology" means the branch of technology1891
devoted to the study and application of data and the processing1892
thereof; the automatic acquisition, storage, manipulation or1893
transformation, management, movement, control, display, switching,1894
interchange, transmission or reception of data, and the1895
development or use of hardware, software, firmware, and procedures1896
associated with this processing. Information technology includes1897
matters concerned with the furtherance of computer science and1898
technology, design, development, installation and implementation1899
of information systems and applications that in turn will be1900
licensed or sold to a specific target market. Information1901
technology does not include the creation of a distribution method1902
for existing products and services.1903

       (E) "Insider" means an individual who owns, controls, or1904
holds power to vote five per cent or more of the outstanding1905
securities of a business. For purposes of determining whether an1906
investor is an insider, the percentage of voting power in the Ohio1907
entity held by a person related to the investor shall be added to1908
the investor's percentage of voting power in the same Ohio entity,1909
if the investor claimed the person related to the investor as a1910
dependent or a spouse on the investor's federal income tax return1911
for the previous tax year.1912

       (F) "Related to" means being the spouse, parent, child, or1913
sibling of an individual.1914

       (G) "Research and development" means designing, creating, or1915
formulating new or enhanced products, equipment, or processes, and1916
conducting scientific or technological inquiry and experimentation1917
in the physical sciences with the goal of increasing scientific1918
knowledge that may reveal the bases for new or enhanced products,1919
equipment, or processes.1920

       (H) "State tax liability" means any tax liability incurred1921
under division (D) of section 5707.03, section 5727.24, 5727.38,1922
or 5747.02, or Chapter 5733. of the Revised Code.1923

       (I) "Technology transfer" means the transfer of technology1924
from one sector of the economy to another, including the transfer1925
of military technology to civilian applications, civilian1926
technology to military applications, or technology from public or1927
private research laboratories to military or civilian1928
applications.1929

       (J) "Affiliated group" means two or more persons related in1930
such a way that one of the persons owns or controls the business1931
operations of another of those persons. In the case of a1932
corporation issuing capital stock, one corporation owns or1933
controls the business operations of another corporation if it owns 1934
more than fifty per cent of the other corporation's capital stock 1935
with voting rights. In the case of a limited liability company, 1936
one person owns or controls the business operations of the company 1937
if that person's membership interest, as defined in section 1938
1705.01 of the Revised Code, is greater than fifty per cent of 1939
combined membership interest of all persons owning such interests 1940
in the company. In the case of an unincorporated business1941
organization, one person owns or controls the business operations 1942
of the organization if, under the articles of organization or 1943
other instrument governing the affairs of the organization, that 1944
person has a beneficial interest in the organization's profits, 1945
surpluses, losses, or other distributions greater than fifty per 1946
cent of the combined beneficial interests of all persons having 1947
such an interest in the organization.1948

       (K) "Money" means United States currency, or a check, draft,1949
or cashier's check for United States currency, payable on demand1950
and drawn on a bank.1951

       (L) "EDGE business enterprise" means an Ohio entity certified 1952
by the director of administrative services as a participant in the 1953
encouraging diversity, growth, and equity program established by 1954
the governor's executive order 2002-17T.1955

       (M) "Distressed area" has the same meaning as in section 1956
122.23 of the Revised Code.1957

       Sec. 124.30.  (A) Positions in the classified service may be1958
filled without competition as follows:1959

       (1) Whenever there are urgent reasons for filling a vacancy1960
in any position in the classified service and the director of1961
administrative services is unable to certify to the appointing1962
authority, upon its request, a list of persons eligible for 1963
appointment to the position after a competitive examination, the 1964
appointing authority may fill the position by noncompetitive1965
examination.1966

        A temporary appointment may be made without regard to the1967
rules of sections 124.01 to 124.64 of the Revised Code. Except as 1968
otherwise provided in this division, the temporary appointment may 1969
not continue longer than one hundred twenty days, and in no case 1970
shall successive temporary appointments be made. A temporary 1971
appointment longer than one hundred twenty days may be made if 1972
necessary by reason of sickness, disability, or other approved 1973
leave of absence of regular officers or employees, in which case 1974
it may continue during the period of sickness, disability, or 1975
other approved leave of absence, subject to the rules of the1976
director.1977

       (2) In case of a vacancy in a position in the classified1978
service where peculiar and exceptional qualifications of a1979
scientific, managerial, professional, or educational character are1980
required, and upon satisfactory evidence that for specified1981
reasons competition in this special case is impracticable and that 1982
the position can best be filled by a selection of some designated 1983
person of high and recognized attainments in those qualities, the 1984
director may suspend the provisions of sections 124.01 to 124.64 1985
of the Revised Code that require competition in this special case, 1986
but no suspension shall be general in its application. All such 1987
cases of suspension shall be reported in the annual report of the 1988
director with the reasons for each suspension. The director shall 1989
suspend the provisions when the director of job and family 1990
services or director of health care administration provides the 1991
certification under section 5101.051 or 5160.05 of the Revised1992
Code that a position with the department of job and family1993
services or department of health care administration can best be 1994
filled if the provisions are suspended.1995

       (3) The acceptance or refusal by an eligible person of a 1996
temporary appointment shall not affect the person's standing on 1997
the eligible list for permanent appointment, nor shall the period 1998
of temporary service be counted as a part of the probationary1999
service in case of subsequent appointment to a permanent position.2000

       (B) Persons who receive temporary or intermittent 2001
appointments are in the unclassified civil service and serve at2002
the pleasure of their appointing authority.2003

       Sec. 124.301.  The director of administrative services shall 2004
waive any residency requirement for the civil service established 2005
by a rule adopted under division (A) of section 124.09 of the 2006
Revised Code if the director of job and family services or 2007
director of health care administration provides the director2008
certification under section 5101.051 or 5160.05 of the Revised 2009
Code that a position with the department of job and family 2010
services or department of health care administration can best be 2011
filled if the residency requirement is waived.2012

       Sec. 127.16.  (A) Upon the request of either a state agency2013
or the director of budget and management and after the controlling2014
board determines that an emergency or a sufficient economic reason2015
exists, the controlling board may approve the making of a purchase2016
without competitive selection as provided in division (B) of this2017
section.2018

       (B) Except as otherwise provided in this section, no state2019
agency, using money that has been appropriated to it directly,2020
shall:2021

       (1) Make any purchase from a particular supplier, that would2022
amount to fifty thousand dollars or more when combined with both2023
the amount of all disbursements to the supplier during the fiscal2024
year for purchases made by the agency and the amount of all2025
outstanding encumbrances for purchases made by the agency from the2026
supplier, unless the purchase is made by competitive selection or2027
with the approval of the controlling board;2028

       (2) Lease real estate from a particular supplier, if the2029
lease would amount to seventy-five thousand dollars or more when2030
combined with both the amount of all disbursements to the supplier2031
during the fiscal year for real estate leases made by the agency2032
and the amount of all outstanding encumbrances for real estate2033
leases made by the agency from the supplier, unless the lease is2034
made by competitive selection or with the approval of the2035
controlling board.2036

       (C) Any person who authorizes a purchase in violation of2037
division (B) of this section shall be liable to the state for any2038
state funds spent on the purchase, and the attorney general shall2039
collect the amount from the person.2040

       (D) Nothing in division (B) of this section shall be2041
construed as:2042

       (1) A limitation upon the authority of the director of2043
transportation as granted in sections 5501.17, 5517.02, and2044
5525.14 of the Revised Code;2045

       (2) Applying to medicaid provider agreements under Chapter2046
5111.5163. or 5164. of the Revised Code or payments or provider 2047
agreements under the disability medical assistance program 2048
established under Chapter 5115.5168. of the Revised Code;2049

       (3) Applying to the purchase of examinations from a sole2050
supplier by a state licensing board under Title XLVII of the2051
Revised Code;2052

       (4) Applying to entertainment contracts for the Ohio state2053
fair entered into by the Ohio expositions commission, provided2054
that the controlling board has given its approval to the2055
commission to enter into such contracts and has approved a total2056
budget amount for such contracts as agreed upon by commission2057
action, and that the commission causes to be kept itemized records2058
of the amounts of money spent under each contract and annually2059
files those records with the clerk of the house of representatives2060
and the clerk of the senate following the close of the fair;2061

       (5) Limiting the authority of the chief of the division of2062
mineral resources management to contract for reclamation work with2063
an operator mining adjacent land as provided in section 1513.27 of2064
the Revised Code;2065

       (6) Applying to investment transactions and procedures of any 2066
state agency, except that the agency shall file with the board the 2067
name of any person with whom the agency contracts to make, broker, 2068
service, or otherwise manage its investments, as well as the 2069
commission, rate, or schedule of charges of such person with2070
respect to any investment transactions to be undertaken on behalf2071
of the agency. The filing shall be in a form and at such times as2072
the board considers appropriate.2073

       (7) Applying to purchases made with money for the per cent2074
for arts program established by section 3379.10 of the Revised2075
Code;2076

       (8) Applying to purchases made by the rehabilitation services 2077
commission of services, or supplies, that are provided to persons 2078
with disabilities, or to purchases made by the commission in 2079
connection with the eligibility determinations it makes for2080
applicants of programs administered by the social security2081
administration;2082

       (9) Applying to payments by the department of job and family2083
serviceshealth care administration under section 5111.135165.302084
of the Revised Code for group health plan premiums, deductibles, 2085
coinsurance, and other cost-sharing expenses;2086

       (10) Applying to any agency of the legislative branch of the2087
state government;2088

       (11) Applying to agreements or contracts entered into under2089
section 5101.11, 5101.20, 5101.201, 5101.21, or 5101.214, 5160.13, 2090
5160.15, or 5160.17 of the Revised Code;2091

       (12) Applying to purchases of services by the adult parole2092
authority under section 2967.14 of the Revised Code or by the2093
department of youth services under section 5139.08 of the Revised2094
Code;2095

       (13) Applying to dues or fees paid for membership in an2096
organization or association;2097

       (14) Applying to purchases of utility services pursuant to2098
section 9.30 of the Revised Code;2099

       (15) Applying to purchases made in accordance with rules2100
adopted by the department of administrative services of motor2101
vehicle, aviation, or watercraft fuel, or emergency repairs of2102
such vehicles;2103

       (16) Applying to purchases of tickets for passenger air2104
transportation;2105

       (17) Applying to purchases necessary to provide public2106
notifications required by law or to provide notifications of job2107
openings;2108

       (18) Applying to the judicial branch of state government;2109

       (19) Applying to purchases of liquor for resale by the2110
division of liquor control;2111

       (20) Applying to purchases of motor courier and freight2112
services made in accordance with department of administrative2113
services rules;2114

       (21) Applying to purchases from the United States postal2115
service and purchases of stamps and postal meter replenishment2116
from vendors at rates established by the United States postal2117
service;2118

       (22) Applying to purchases of books, periodicals, pamphlets,2119
newspapers, maintenance subscriptions, and other published2120
materials;2121

       (23) Applying to purchases from other state agencies,2122
including state-assisted institutions of higher education;2123

       (24) Limiting the authority of the director of environmental2124
protection to enter into contracts under division (D) of section2125
3745.14 of the Revised Code to conduct compliance reviews, as2126
defined in division (A) of that section;2127

       (25) Applying to purchases from a qualified nonprofit agency2128
pursuant to sections 125.60 to 125.6012 or 4115.31 to 4115.35 of 2129
the Revised Code;2130

       (26) Applying to payments by the department of job and family2131
services to the United States department of health and human2132
services for printing and mailing notices pertaining to the tax2133
refund offset program of the internal revenue service of the2134
United States department of the treasury;2135

       (27) Applying to contracts entered into by the department of2136
mental retardation and developmental disabilities under section 2137
5123.18 of the Revised Code;2138

       (28) Applying to payments made by the department of mental2139
health under a physician recruitment program authorized by section2140
5119.101 of the Revised Code;2141

       (29) Applying to contracts entered into with persons by the2142
director of commerce for unclaimed funds collection and remittance2143
efforts as provided in division (F) of section 169.03 of the2144
Revised Code. The director shall keep an itemized accounting of2145
unclaimed funds collected by those persons and amounts paid to2146
them for their services.2147

       (30) Applying to purchases made by a state institution of2148
higher education in accordance with the terms of a contract2149
between the vendor and an inter-university purchasing group2150
comprised of purchasing officers of state institutions of higher2151
education;2152

       (31) Applying to the department of job and family services'2153
health care administration's purchases of health assistance 2154
services under the children's health insurance program part I 2155
provided for under section 5101.50 of the Revised Code, the 2156
children's health insurance program part II provided for under 2157
section 5101.51 of the Revised Code, or the children's health 2158
insurance program part III provided for under section 5101.52 of 2159
the Revised Code, or the children's buy-in program provided for 2160
under sections 5101.5211 to 5101.5216 of the Revised Code;2161

       (32) Applying to payments by the attorney general from the2162
reparations fund to hospitals and other emergency medical2163
facilities for performing medical examinations to collect physical2164
evidence pursuant to section 2907.28 of the Revised Code;2165

       (33) Applying to contracts with a contracting authority or2166
administrative receiver under division (B) of section 5126.056 of 2167
the Revised Code;2168

       (34) Applying to reimbursements paid to the United States 2169
department of veterans affairs for pharmaceutical and patient 2170
supply purchases made on behalf of the Ohio veterans' home agency;2171

       (35) Applying to agreements entered into with terminal 2172
distributors of dangerous drugs under section 173.79 of the 2173
Revised Code;2174

       (36) Applying to payments by the superintendent of the bureau 2175
of criminal identification and investigation to the federal bureau 2176
of investigation for criminal records checks pursuant to section 2177
109.572 of the Revised Code.2178

       (E) When determining whether a state agency has reached the2179
cumulative purchase thresholds established in divisions (B)(1) and 2180
(2) of this section, all of the following purchases by such agency 2181
shall not be considered:2182

       (1) Purchases made through competitive selection or with2183
controlling board approval;2184

       (2) Purchases listed in division (D) of this section;2185

       (3) For the purposes of the threshold of division (B)(1) of 2186
this section only, leases of real estate.2187

       (F) As used in this section, "competitive selection,"2188
"purchase," "supplies," and "services" have the same meanings as2189
in section 125.01 of the Revised Code.2190

       Sec. 131.23.  The various political subdivisions of this2191
state may issue bonds, and any indebtedness created by that2192
issuance shall not be subject to the limitations or included in2193
the calculation of indebtedness prescribed by sections 133.05,2194
133.06, 133.07, and 133.09 of the Revised Code, but the bonds may 2195
be issued only under the following conditions:2196

       (A) The subdivision desiring to issue the bonds shall obtain 2197
from the county auditor a certificate showing the total amount of 2198
delinquent taxes due and unpayable to the subdivision at the last 2199
semiannual tax settlement.2200

       (B) The fiscal officer of that subdivision shall prepare a2201
statement, from the books of the subdivision, verified by the2202
fiscal officer under oath, which shall contain the following facts 2203
of the subdivision:2204

       (1) The total bonded indebtedness;2205

       (2) The aggregate amount of notes payable or outstanding2206
accounts of the subdivision, incurred prior to the commencement of 2207
the current fiscal year, which shall include all evidences of2208
indebtedness issued by the subdivision except notes issued in2209
anticipation of bond issues and the indebtedness of any2210
nontax-supported public utility;2211

       (3) Except in the case of school districts, the aggregate2212
current year's requirement for disability financial assistance and 2213
disability medical assistance provided under Chapter 5115.5168.2214
of the Revised Code and the disability medical assistance program2215
that the subdivision is unable to finance except by the issue of 2216
bonds;2217

       (4) The indebtedness outstanding through the issuance of any 2218
bonds or notes pledged or obligated to be paid by any delinquent 2219
taxes;2220

       (5) The total of any other indebtedness;2221

       (6) The net amount of delinquent taxes unpledged to pay any 2222
bonds, notes, or certificates, including delinquent assessments on 2223
improvements on which the bonds have been paid;2224

       (7) The budget requirements for the fiscal year for bond and 2225
note retirement;2226

       (8) The estimated revenue for the fiscal year.2227

       (C) The certificate and statement provided for in divisions 2228
(A) and (B) of this section shall be forwarded to the tax 2229
commissioner together with a request for authority to issue bonds 2230
of the subdivision in an amount not to exceed seventy per cent of 2231
the net unobligated delinquent taxes and assessments due and owing 2232
to the subdivision, as set forth in division (B)(6) of this 2233
section.2234

       (D) No subdivision may issue bonds under this section in2235
excess of a sufficient amount to pay the indebtedness of the2236
subdivision as shown by division (B)(2) of this section and,2237
except in the case of school districts, to provide funds for2238
disability financial assistance and disability medical assistance, 2239
as shown by division (B)(3) of this section.2240

       (E) The tax commissioner shall grant to the subdivision2241
authority requested by the subdivision as restricted by divisions 2242
(C) and (D) of this section and shall make a record of the 2243
certificate, statement, and grant in a record book devoted solely 2244
to such recording and which shall be open to inspection by the 2245
public.2246

       (F) The commissioner shall immediately upon issuing the2247
authority provided in division (E) of this section notify the2248
proper authority having charge of the retirement of bonds of the2249
subdivision by forwarding a copy of the grant of authority and of 2250
the statement provided for in division (B) of this section.2251

       (G) Upon receipt of authority, the subdivision shall proceed 2252
according to law to issue the amount of bonds authorized by the 2253
commissioner, and authorized by the taxing authority, provided the 2254
taxing authority of that subdivision may submit, by resolution, to 2255
the electors of that subdivision the question of issuing the 2256
bonds. The resolution shall make the declarations and statements 2257
required by section 133.18 of the Revised Code. The county auditor 2258
and taxing authority shall thereupon proceed as set forth in 2259
divisions (C) and (D) of that section. The election on the 2260
question of issuing the bonds shall be held under divisions (E), 2261
(F), and (G) of that section, except that publication of the 2262
notice of the election shall be made on two separate days prior to 2263
the election in one or more newspapers of general circulation in 2264
the subdivision, and, if the board of elections operates and 2265
maintains a web site, notice of the election also shall be posted 2266
on that web site for thirty days prior to the election. The bonds 2267
may be exchanged at their face value with creditors of the2268
subdivision in liquidating the indebtedness described and2269
enumerated in division (B)(2) of this section or may be sold as2270
provided in Chapter 133. of the Revised Code, and in either event2271
shall be uncontestable.2272

       (H) The per cent of delinquent taxes and assessments2273
collected for and to the credit of the subdivision after the2274
exchange or sale of bonds as certified by the commissioner shall2275
be paid to the authority having charge of the sinking fund of the2276
subdivision, which money shall be placed in a separate fund for2277
the purpose of retiring the bonds so issued. The proper authority 2278
of the subdivisions shall provide for the levying of a tax 2279
sufficient in amount to pay the debt charges on all such bonds 2280
issued under this section.2281

       (I) This section is for the sole purpose of assisting the2282
various subdivisions in paying their unsecured indebtedness, and2283
providing funds for disability financial assistance and the2284
disability medical assistance program. The bonds issued under 2285
authority of this section shall not be used for any other purpose, 2286
and any exchange for other purposes, or the use of the money 2287
derived from the sale of the bonds by the subdivision for any 2288
other purpose, is misapplication of funds.2289

       (J) The bonds authorized by this section shall be redeemable 2290
or payable in not to exceed ten years from date of issue and shall 2291
not be subject to or considered in calculating the net 2292
indebtedness of the subdivision. The budget commission of the 2293
county in which the subdivision is located shall annually allocate 2294
such portion of the then delinquent levy due the subdivision which 2295
is unpledged for other purposes to the payment of debt charges on 2296
the bonds issued under authority of this section.2297

       (K) The issue of bonds under this section shall be governed 2298
by Chapter 133. of the Revised Code, respecting the terms used, 2299
forms, manner of sale, and redemption except as otherwise provided 2300
in this section.2301

       The board of county commissioners of any county may issue2302
bonds authorized by this section and distribute the proceeds of 2303
the bond issues to any or all of the cities and townships of the 2304
county, according to their relative needs for disability financial 2305
assistance and the disability medical assistance program as 2306
determined by the county.2307

       All sections of the Revised Code inconsistent with or2308
prohibiting the exercise of the authority conferred by this2309
section are inoperative respecting bonds issued under this2310
section.2311

       Sec. 145.27.  (A)(1) As used in this division, "personal2312
history record" means information maintained by the public2313
employees retirement board on an individual who is a member,2314
former member, contributor, former contributor, retirant, or2315
beneficiary that includes the address, telephone number, social2316
security number, record of contributions, correspondence with the2317
public employees retirement system, or other information the board2318
determines to be confidential.2319

       (2) The records of the board shall be open to public2320
inspection, except that the following shall be excluded, except2321
with the written authorization of the individual concerned:2322

       (a) The individual's statement of previous service and other2323
information as provided for in section 145.16 of the Revised Code;2324

       (b) The amount of a monthly allowance or benefit paid to the2325
individual;2326

       (c) The individual's personal history record.2327

       (B) All medical reports and recommendations required by this2328
chapter are privileged, except that copies of such medical reports2329
or recommendations shall be made available to the personal2330
physician, attorney, or authorized agent of the individual2331
concerned upon written release from the individual or the2332
individual's agent, or when necessary for the proper2333
administration of the fund, to the board assigned physician.2334

       (C) Any person who is a member or contributor of the system2335
shall be furnished with a statement of the amount to the credit of2336
the individual's account upon written request. The board is not2337
required to answer more than one such request of a person in any2338
one year. The board may issue annual statements of accounts to2339
members and contributors.2340

       (D) Notwithstanding the exceptions to public inspection in2341
division (A)(2) of this section, the board may furnish the2342
following information:2343

       (1) If a member, former member, contributor, former2344
contributor, or retirant is subject to an order issued under2345
section 2907.15 of the Revised Code or an order issued under 2346
division (A) or (B) of section 2929.192 of the Revised Code or is 2347
convicted of or pleads guilty to a violation of section 2921.41 of 2348
the Revised Code, on written request of a prosecutor as defined in 2349
section 2935.01 of the Revised Code, the board shall furnish to 2350
the prosecutor the information requested from the individual's 2351
personal history record.2352

       (2) Pursuant to a court or administrative order issued2353
pursuant to Chapter 3119., 3121., 3123., or 3125. of the Revised2354
Code, the board shall furnish to a court or child support2355
enforcement agency the information required under that section.2356

       (3) At the written request of any person, the board shall2357
provide to the person a list of the names and addresses of2358
members, former members, contributors, former contributors,2359
retirants, or beneficiaries. The costs of compiling, copying, and2360
mailing the list shall be paid by such person.2361

       (4) Within fourteen days after receiving from the director of 2362
job and family services a list of the names and social security2363
numbers of recipients of public assistance pursuant to section2364
5101.181 of the Revised Code or a list of the names and social 2365
security numbers of public medical assistance recipients pursuant 2366
to section 5160.43 of the Revised Code, the board shall inform the 2367
auditor of state of the name, current or most recent employer 2368
address, and social security number of each member whose name and 2369
social security number are the same as that of a person whose name 2370
or social security number was submitted by the directoris 2371
included on the list. The board and its employees shall, except 2372
for purposes of furnishing the auditor of state with information 2373
required by this section, preserve the confidentiality of 2374
recipients of public assistance in compliance with division (A) of2375
section 5101.181 of the Revised Code and preserve the 2376
confidentiality of public medical assistance recipients with 2377
section 5160.43 of the Revised Code.2378

       (5) The system shall comply with orders issued under section2379
3105.87 of the Revised Code.2380

       On the written request of an alternate payee, as defined in2381
section 3105.80 of the Revised Code, the system shall furnish to2382
the alternate payee information on the amount and status of any2383
amounts payable to the alternate payee under an order issued under2384
section 3105.171 or 3105.65 of the Revised Code.2385

       (6) At the request of any person, the board shall make 2386
available to the person copies of all documents, including 2387
resumes, in the board's possession regarding filling a vacancy of 2388
an employee member or retirant member of the board. The person who 2389
made the request shall pay the cost of compiling, copying, and 2390
mailing the documents. The information described in division 2391
(D)(6) of this section is a public record.2392

       (E) A statement that contains information obtained from the2393
system's records that is signed by the executive director or an2394
officer of the system and to which the system's official seal is2395
affixed, or copies of the system's records to which the signature2396
and seal are attached, shall be received as true copies of the2397
system's records in any court or before any officer of this state.2398

       Sec. 145.58.  (A) As used in this section, "ineligible2399
individual" means all of the following:2400

       (1) A former member receiving benefits pursuant to section2401
145.32, 145.33, 145.331, 145.34, or 145.46 of the Revised Code for2402
whom eligibility is established more than five years after June2403
13, 1981, and who, at the time of establishing eligibility, has2404
accrued less than ten years' service credit, exclusive of credit2405
obtained pursuant to section 145.297 or 145.298 of the Revised2406
Code, credit obtained after January 29, 1981, pursuant to section2407
145.293 or 145.301 of the Revised Code, and credit obtained after2408
May 4, 1992, pursuant to section 145.28 of the Revised Code;2409

       (2) The spouse of the former member;2410

       (3) The beneficiary of the former member receiving benefits2411
pursuant to section 145.46 of the Revised Code.2412

       (B) The public employees retirement board may enter into2413
agreements with insurance companies, health insuring corporations,2414
or government agencies authorized to do business in the state for2415
issuance of a policy or contract of health, medical, hospital, or2416
surgical benefits, or any combination thereof, for those2417
individuals receiving age and service retirement or a disability2418
or survivor benefit subscribing to the plan, or for PERS retirants2419
employed under section 145.38 of the Revised Code, for coverage of2420
benefits in accordance with division (D)(2) of section 145.38 of2421
the Revised Code. Notwithstanding any other provision of this2422
chapter, the policy or contract may also include coverage for any2423
eligible individual's spouse and dependent children and for any of2424
the individual's sponsored dependents as the board determines2425
appropriate. If all or any portion of the policy or contract2426
premium is to be paid by any individual receiving age and service2427
retirement or a disability or survivor benefit, the individual2428
shall, by written authorization, instruct the board to deduct the2429
premium agreed to be paid by the individual to the company,2430
corporation, or agency.2431

       The board may contract for coverage on the basis of part or2432
all of the cost of the coverage to be paid from appropriate funds2433
of the public employees retirement system. The cost paid from the2434
funds of the system shall be included in the employer's2435
contribution rate provided by sections 145.48 and 145.51 of the2436
Revised Code. The board may by rule provide coverage to ineligible 2437
individuals if the coverage is provided at no cost to the 2438
retirement system. The board shall not pay or reimburse the cost 2439
for coverage under this section or section 145.325 of the Revised 2440
Code for any ineligible individual.2441

       The board may provide for self-insurance of risk or level of2442
risk as set forth in the contract with the companies,2443
corporations, or agencies, and may provide through the2444
self-insurance method specific benefits as authorized by rules of2445
the board.2446

       (C) The board shall, beginning the month following receipt of2447
satisfactory evidence of the payment for coverage, pay monthly to2448
each recipient of service retirement, or a disability or survivor2449
benefit under the public employees retirement system who is2450
eligible for medical insurance coverage under part B of Title2451
XVIII of "The Social Security Act," 79 Stat. 301 (1965), 422452
U.S.C.A. 1395j, as amendedthe medicare program, an amount 2453
determined by the board for such coverage that is not less than 2454
ninety-six dollars and forty cents, except that the board shall 2455
make no such payment to any ineligible individual or pay an 2456
amount that exceeds the amount paid by the recipient for the 2457
coverage.2458

       At the request of the board, the recipient shall certify to 2459
the retirement system the amount paid by the recipient for 2460
coverage described in this division.2461

       (D) The board shall establish by rule requirements for the2462
coordination of any coverage, payment, or benefit provided under2463
this section or section 145.325 of the Revised Code with any2464
similar coverage, payment, or benefit made available to the same2465
individual by the Ohio police and fire pension fund, state2466
teachers retirement system, school employees retirement system, or2467
state highway patrol retirement system.2468

       (E) The board shall make all other necessary rules pursuant2469
to the purpose and intent of this section.2470

       Sec. 149.431.  (A) Any governmental entity or agency and any 2471
nonprofit corporation or association, except a corporation2472
organized pursuant to Chapter 1719. of the Revised Code prior to2473
January 1, 1980 or organized pursuant to Chapter 3941. of the2474
Revised Code, that enters into a contract or other agreement with2475
the federal government, a unit of state government, or a political 2476
subdivision or taxing unit of this state for the provision of 2477
services shall keep accurate and complete financial records of any 2478
moneys expended in relation to the performance of the services 2479
pursuant to such contract or agreement according to generally 2480
accepted accounting principles. Such contract or agreement and 2481
such financial records shall be deemed to be public records as 2482
defined in division (A)(1) of section 149.43 of the Revised Code 2483
and are subject to the requirements of division (B) of that 2484
section, except that:2485

       (1) Any information directly or indirectly identifying a2486
present or former individual patient or client or hissuch an2487
individual patient's or client's diagnosis, prognosis, or medical 2488
treatment, treatment for a mental or emotional disorder, treatment 2489
for mental retardation or a developmental disability, treatment 2490
for drug abuse or alcoholism, or counseling for personal or social 2491
problems is not a public record;2492

       (2) If disclosure of the contract or agreement or financial 2493
records is requested at a time when confidential professional 2494
services are being provided to a patient or client whose 2495
confidentiality might be violated if disclosure were made at that 2496
time, disclosure may be deferred if reasonable times are2497
established when the contract or agreement or financial records2498
will be disclosed.2499

       (3) Any nonprofit corporation or association that receives2500
both public and private funds in fulfillment of any such contract2501
or other agreement is not required to keep as public records the2502
financial records of any private funds expended in relation to the 2503
performance of services pursuant to the contract or agreement.2504

       (B) Any nonprofit corporation or association that receives2505
more than fifty per cent of its gross receipts excluding moneys2506
received pursuant to Title XVIII of the "Social Security Act," 492507
Stat. 620 (1935), 42 U.S.C. 301, as amendedmedicare program, in a 2508
calendar year in fulfillment of a contract or other agreement for 2509
services with a governmental entity shall maintain information 2510
setting forth the compensation of any individual serving the 2511
nonprofit corporation or association in an executive or 2512
administrative capacity. Such information shall be deemed to be 2513
public records as defined in division (A)(1) of section 149.43 of 2514
the Revised Code and is subject to the requirements of division 2515
(B) of that section.2516

       Nothing in this section shall be construed to otherwise limit 2517
the provisions of section 149.43 of the Revised Code.2518

       Sec. 169.02.  Subject to division (B) of section 169.01 of2519
the Revised Code, the following constitute unclaimed funds:2520

       (A) Except as provided in division (R) of this section, any2521
demand, savings, or matured time deposit account, or matured2522
certificate of deposit, together with any interest or dividend on2523
it, less any lawful claims, that is held or owed by a holder which2524
is a financial organization, unclaimed for a period of five years;2525

       (B) Any funds paid toward the purchase of withdrawable shares 2526
or other interest in a financial organization, and any interest or 2527
dividends on them, less any lawful claims, that is held or owed by 2528
a holder which is a financial organization, unclaimed for a period 2529
of five years;2530

       (C) Except as provided in division (A) of section 3903.45 of2531
the Revised Code, moneys held or owed by a holder, including a2532
fraternal association, providing life insurance, including annuity2533
or endowment coverage, unclaimed for three years after becoming2534
payable as established from the records of such holder under any2535
life or endowment insurance policy or annuity contract that has2536
matured or terminated. An insurance policy, the proceeds of which2537
are payable on the death of the insured, not matured by proof of2538
death of the insured is deemed matured and the proceeds payable if2539
such policy was in force when the insured attained the limiting2540
age under the mortality table on which the reserve is based.2541

       Moneys otherwise payable according to the records of such2542
holder are deemed payable although the policy or contract has not2543
been surrendered as required.2544

       (D) Any deposit made to secure payment or any sum paid in2545
advance for utility services of a public utility and any amount2546
refundable from rates or charges collected by a public utility for2547
utility services held or owed by a holder, less any lawful claims,2548
that has remained unclaimed for one year after the termination of2549
the services for which the deposit or advance payment was made or2550
one year from the date the refund was payable, whichever is2551
earlier;2552

       (E) Except as provided in division (R) of this section, any2553
certificates, securities as defined in section 1707.01 of the2554
Revised Code, nonwithdrawable shares, other instruments evidencing2555
ownership, or rights to them or funds paid toward the purchase of2556
them, or any dividend, capital credit, profit, distribution,2557
interest, or payment on principal or other sum, held or owed by a2558
holder, including funds deposited with a fiscal agent or fiduciary2559
for payment of them, and instruments representing an ownership2560
interest, unclaimed for five years. Any underlying share or other2561
intangible instrument representing an ownership interest in a2562
business association, in which the issuer has recorded on its2563
books the issuance of the share but has been unable to deliver the2564
certificate to the shareholder, constitutes unclaimed funds if2565
such underlying share is unclaimed for five years. In addition, an 2566
underlying share constitutes unclaimed funds if a dividend,2567
distribution, or other sum payable as a result of the underlying2568
share has remained unclaimed by the owner for five years.2569

       This division shall not prejudice the rights of fiscal agents2570
or fiduciaries for payment to return the items described in this2571
division to their principals, according to the terms of an agency2572
or fiduciary agreement, but such a return shall constitute the2573
principal as the holder of the items and shall not interrupt the2574
period for computing the time for which the items have remained2575
unclaimed.2576

       In the case of any such funds accruing and held or owed by a2577
corporation under division (E) of section 1701.24 of the Revised2578
Code, such corporation shall comply with this chapter, subject to2579
the limitation contained in section 1701.34 of the Revised Code.2580
The period of time for which such funds have gone unclaimed2581
specified in section 1701.34 of the Revised Code shall be2582
computed, with respect to dividends or distributions, commencing2583
as of the dates when such dividends or distributions would have2584
been payable to the shareholder had such shareholder surrendered2585
the certificates for cancellation and exchange by the date2586
specified in the order relating to them.2587

       Capital credits of a cooperative which after January 1, 1972,2588
have been allocated to members and which by agreement are2589
expressly required to be paid if claimed after death of the owner2590
are deemed payable, for the purpose of this chapter, fifteen years2591
after either the termination of service by the cooperative to the2592
owner or upon the nonactivity as provided in division (B) of2593
section 169.01 of the Revised Code, whichever occurs later,2594
provided that this provision does not apply if the payment is not2595
mandatory.2596

       (F) Any sum payable on certified checks or other written2597
instruments certified or issued and representing funds held or2598
owed by a holder, less any lawful claims, that are unclaimed for2599
five years from the date payable or from the date of issuance if2600
payable on demand; except that the unclaimed period for money2601
orders that are not third party bank checks is seven years, and2602
the unclaimed period for traveler's checks is fifteen years, from2603
the date payable or from the date of issuance if payable on2604
demand.2605

       As used in this division, "written instruments" include, but2606
are not limited to, certified checks, cashier's checks, bills of2607
exchange, letters of credit, drafts, money orders, and traveler's2608
checks.2609

       If there is no address of record for the owner or other2610
person entitled to the funds, such address is presumed to be the2611
address where the instrument was certified or issued.2612

       (G) Except as provided in division (R) of this section, all2613
moneys, rights to moneys, or other intangible property, arising2614
out of the business of engaging in the purchase or sale of2615
securities, or otherwise dealing in intangibles, less any lawful2616
claims, that are held or owed by a holder and are unclaimed for2617
five years from the date of transaction.2618

       (H) Except as provided in division (A) of section 3903.45 of2619
the Revised Code, all moneys, rights to moneys, and other2620
intangible property distributable in the course of dissolution or2621
liquidation of a holder that are unclaimed for one year after the2622
date set by the holder for distribution;2623

       (I) All moneys, rights to moneys, or other intangible2624
property removed from a safe-deposit box or other safekeeping2625
repository located in this state or removed from a safe-deposit2626
box or other safekeeping repository of a holder, on which the2627
lease or rental period has expired, or any amount arising from the2628
sale of such property, less any lawful claims, that are unclaimed2629
for three years from the date on which the lease or rental period2630
expired;2631

       (J) Subject to division (M)(2) of this section, all moneys,2632
rights to moneys, or other intangible property, and any income or2633
increment on them, held or owed by a holder which is a fiduciary2634
for the benefit of another, or a fiduciary or custodian of a2635
qualified retirement plan or individual retirement arrangement2636
under section 401 or 408 of the Internal Revenue Code, unclaimed2637
for three years after the final date for distribution;2638

       (K) All moneys, rights to moneys, or other intangible2639
property held or owed in this state or held for or owed to an2640
owner whose last known address is within this state, by the United2641
States government or any state, as those terms are described in2642
division (E) of section 169.01 of the Revised Code, unclaimed by2643
the owner for three years, excluding any property in the control2644
of any court in a proceeding in which a final adjudication has not2645
been made;2646

       (L) Amounts payable pursuant to the terms of any policy of2647
insurance, other than life insurance, or any refund available2648
under such a policy, held or owed by any holder, unclaimed for2649
three years from the date payable or distributable;2650

       (M)(1) Subject to division (M)(2) of this section, any funds2651
constituting rents or lease payments due, any deposit made to2652
secure payment of rents or leases, or any sum paid in advance for2653
rents, leases, possible damage to property, unused services,2654
performance requirements, or any other purpose, held or owed by a2655
holder unclaimed for one year;2656

       (2) Any escrow funds, security deposits, or other moneys that 2657
are received by a licensed broker in a fiduciary capacity and2658
that, pursuant to division (A)(26) of section 4735.18 of the2659
Revised Code, are required to be deposited into and maintained in2660
a special or trust, noninterest-bearing bank account separate and2661
distinct from any personal or other account of the licensed2662
broker, held or owed by the licensed broker unclaimed for two2663
years.2664

       (N) Any sum greater than fifty dollars payable as wages, any2665
sum payable as salaries or commissions, any sum payable for2666
services rendered, funds owed or held as royalties, oil and2667
mineral proceeds, funds held for or owed to suppliers, and moneys2668
owed under pension and profit-sharing plans, held or owed by any2669
holder unclaimed for one year from date payable or distributable,2670
and all other credits held or owed, or to be refunded to a retail2671
customer, by any holder unclaimed for three years from date2672
payable or distributable;2673

       (O) Amounts held in respect of or represented by lay-aways2674
sold after January 1, 1972, less any lawful claims, when such2675
lay-aways are unclaimed for three years after the sale of them;2676

       (P) All moneys, rights to moneys, and other intangible2677
property not otherwise constituted as unclaimed funds by this2678
section, including any income or increment on them, less any2679
lawful claims, which are held or owed by any holder, other than a2680
holder which holds a permit issued pursuant to Chapter 3769. of2681
the Revised Code, and which have remained unclaimed for three2682
years after becoming payable or distributable;2683

       (Q) All moneys that arise out of a sale held pursuant to2684
section 5322.03 of the Revised Code, that are held by a holder for2685
delivery on demand to the appropriate person pursuant to division2686
(I) of that section, and that are unclaimed for two years after2687
the date of the sale.2688

       (R)(1) Any funds that are subject to an agreement between the 2689
holder and owner providing for automatic reinvestment and that2690
constitute dividends, distributions, or other sums held or owed by2691
a holder in connection with a security as defined in section2692
1707.01 of the Revised Code, an ownership interest in an2693
investment company registered under the "Investment Company Act of2694
1940," 54 Stat. 789, 15 U.S.C. 80a-1, as amended, or a certificate2695
of deposit, unclaimed for a period of five years.2696

       (2) The five-year period under division (R)(1) of this2697
section commences from the date a second shareholder notification2698
or communication mailing to the owner of the funds is returned to2699
the holder as undeliverable by the United States postal service or2700
other carrier. The notification or communication mailing by the2701
holder shall be no less frequent than quarterly.2702

       All moneys in a personal allowance account, as defined by2703
rules adopted by the director of job and family serviceshealth 2704
care administration, up to and including the maximum resource 2705
limitation, of a medicaid patient who has died after receiving 2706
care in a long-term care facility, and for whom there is no 2707
identifiable heir or sponsor, are not subject to this chapter.2708

       Sec. 173.14.  As used in sections 173.14 to 173.27 of the2709
Revised Code:2710

       (A)(1) Except as otherwise provided in division (A)(2) of2711
this section, "long-term care facility" includes any residential2712
facility that provides personal care services for more than2713
twenty-four hours for two or more unrelated adults, including all2714
of the following:2715

       (a) A "nursing home," "residential care facility," or "home2716
for the aging" as defined in section 3721.01 of the Revised Code;2717

       (b) A facility authorized to provide extended care services 2718
under Title XVIII of the "Social Security Act," 49 Stat. 620 2719
(1935), 42 U.S.C. 301, as amendedmedicare program;2720

       (c) A county home or district home operated pursuant to2721
Chapter 5155. of the Revised Code;2722

       (d) An "adult care facility" as defined in section 3722.01 of 2723
the Revised Code;2724

       (e) A facility approved by the veterans administration under 2725
section 104(a) of the "Veterans Health Care Amendments of 1983," 2726
97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for 2727
the placement and care of veterans;2728

       (f) An adult foster home certified under section 173.36 of2729
the Revised Code.2730

       (2) "Long-term care facility" does not include a "residential 2731
facility" as defined in section 5119.22 of the Revised Code or a 2732
"residential facility" as defined in section 5123.19 of the 2733
Revised Code.2734

       (B) "Resident" means a resident of a long-term care facility 2735
and, where appropriate, includes a prospective, previous, or 2736
deceased resident of a long-term care facility.2737

       (C) "Community-based long-term care services" means health2738
and social services provided to persons in their own homes or in 2739
community care settings, and includes any of the following:2740

       (1) Case management;2741

       (2) Home health care;2742

       (3) Homemaker services;2743

       (4) Chore services;2744

       (5) Respite care;2745

       (6) Adult day care;2746

       (7) Home-delivered meals;2747

       (8) Personal care;2748

       (9) Physical, occupational, and speech therapy;2749

       (10) Transportation;2750

       (11) Any other health and social services provided to persons 2751
that allow them to retain their independence in their own homes or 2752
in community care settings.2753

       (D) "Recipient" means a recipient of community-based2754
long-term care services and, where appropriate, includes a2755
prospective, previous, or deceased recipient of community-based2756
long-term care services.2757

       (E) "Sponsor" means an adult relative, friend, or guardian2758
who has an interest in or responsibility for the welfare of a2759
resident or a recipient.2760

       (F) "Personal care services" has the same meaning as in2761
section 3721.01 of the Revised Code.2762

       (G) "Regional long-term care ombudsperson program" means an2763
entity, either public or private and nonprofit, designated as a2764
regional long-term care ombudsperson program by the state 2765
long-term care ombudsperson.2766

       (H) "Representative of the office of the state long-term care 2767
ombudsperson program" means the state long-term care ombudsperson2768
or a member of the ombudsperson's staff, or a person certified as 2769
a representative of the office under section 173.21 of the Revised2770
Code.2771

       (I) "Area agency on aging" means an area agency on aging2772
established under the "Older Americans Act of 1965," 79 Stat. 219, 2773
42 U.S.C.A. 3001, as amended.2774

       Sec. 173.20.  (A) If consent is given and unless otherwise2775
prohibited by law, a representative of the office of the state2776
long-term care ombudsmanombudsperson program shall have access to 2777
any records, including medical records, of a resident or a 2778
recipient that are reasonably necessary for investigation of a 2779
complaint. Consent may be given in any of the following ways:2780

       (1) In writing by the resident or recipient;2781

       (2) Orally by the resident or recipient, witnessed in writing 2782
at the time it is given by one other person, and, if the records 2783
involved are being maintained by a long-term care provider, also 2784
by an employee of the long-term care provider designated under 2785
division (E)(1) of this section;2786

       (3) In writing by the guardian of the resident or recipient;2787

       (4) In writing by the attorney in fact of the resident or2788
recipient, if the resident or recipient has authorized the2789
attorney in fact to give such consent;2790

       (5) In writing by the executor or administrator of the estate 2791
of a deceased resident or recipient.2792

       (B) If consent to access to records is not refused by a2793
resident or recipient or histhe resident's or recipient's legal2794
representative but cannot be obtained and any of the following 2795
circumstances exist, a representative of the office of the state 2796
long-term care ombudsmanombudsperson program, on approval of the 2797
state long-term care ombudsmanombudsperson, may inspect the 2798
records of a resident or a recipient, including medical records, 2799
that are reasonably necessary for investigation of a complaint:2800

       (1) The resident or recipient is unable to express written or 2801
oral consent and there is no guardian or attorney in fact;2802

       (2) There is a guardian or attorney in fact, but hethe 2803
guardian or attorney in fact cannot be contacted within three 2804
working days;2805

       (3) There is a guardianship or durable power of attorney, but 2806
its existence is unknown by the long-term care provider and the 2807
representative of the office at the time of the investigation;2808

       (4) There is no executor or administrator of the estate of a 2809
deceased resident or recipient.2810

       (C) If a representative of the office of the state long-term 2811
care ombudsmanombudsperson program has been refused access to2812
records by a guardian or attorney in fact, but has reasonable2813
cause to believe that the guardian or attorney in fact is not2814
acting in the best interests of the resident or recipient, the2815
representative may, on approval of the state long-term care2816
ombudsmanombudsperson, inspect the records of the resident or 2817
recipient, including medical records, that are reasonably 2818
necessary for investigation of a complaint.2819

       (D) A representative of the office of the state long-term2820
care ombudsmanombudsperson program shall have access to any 2821
records of a long-term care provider reasonably necessary to an 2822
investigation conducted under this section, including but not 2823
limited to: incident reports, dietary records, policies and 2824
procedures of a facility required to be maintained under section 2825
5111.215164.02 of the Revised Code, admission agreements, 2826
staffing schedules, any document depicting the actual staffing 2827
pattern of the provider, any financial records that are matters of 2828
public record, resident council and grievance committee minutes, 2829
and any waiting list maintained by a facility in accordance with 2830
section 5111.315164.033 of the Revised Code, or any similar 2831
records or lists maintained by a provider of community-based 2832
long-term care services. Pursuant to division (E)(2) of this 2833
section, a representative shall be permitted to make or obtain 2834
copies of any of these records after giving the long-term care 2835
provider twenty-four hours' notice. A long-term care provider may 2836
impose a charge for providing copies of records under this 2837
division that does not exceed the actual and necessary expense of 2838
making the copies.2839

       The state ombudsmanombudsperson shall take whatever action 2840
is necessary to ensure that any copy of a record made or obtained 2841
under this division is returned to the long-term care provider no 2842
later than three years after the date the investigation for which 2843
the copy was made or obtained is completed.2844

       (E)(1) Each long-term care provider shall designate one or2845
more of its employees to be responsible for witnessing the giving2846
of oral consent under division (A) of this section. In the event2847
that a designated employee is not available when a resident or2848
recipient attempts to give oral consent, the provider shall2849
designate another employee to witness the consent.2850

       (2) Each long-term care provider shall designate one or more 2851
of its employees to be responsible for releasing records for2852
copying to representatives of the office of the long-term care2853
ombudsmanombudsperson program who request permission to make or 2854
obtain copies of records specified in division (D) of this 2855
section. In the event that a designated employee is not available 2856
when a representative of the office makes the request, the 2857
long-term care provider shall designate another employee to 2858
release the records for copying.2859

       (F) A long-term care provider or any employee of such a2860
provider is immune from civil or criminal liability or action2861
taken pursuant to a professional disciplinary procedure for the2862
release or disclosure of records to a representative of the office 2863
pursuant to this section.2864

       (G) A state or local government agency or entity with records 2865
relevant to a complaint or investigation being conducted by a 2866
representative of the office shall provide the representative 2867
access to the records.2868

       (H) The state ombudsmanombudsperson, with the approval of 2869
the director of aging, may issue a subpoena to compel any person 2870
hethe ombudsperson reasonably believes may be able to provide 2871
information to appear before himthe ombudsperson or histhe2872
ombudsperson's designee and give sworn testimony and to produce2873
documents, books, records, papers, or other evidence the state2874
ombudsmanombudsperson believes is relevant to the investigation. 2875
On the refusal of a witness to be sworn or to answer any question 2876
put to himthe witness, or if a person disobeys a subpoena, the2877
ombudsmanombudsperson shall apply to the Franklin county court of 2878
common pleas for a contempt order, as in the case of disobedience 2879
of the requirements of a subpoena issued from the court, or a 2880
refusal to testify in the court.2881

       (I) The state ombudsmanombudsperson may petition the court 2882
of common pleas in the county in which a long-term care facility 2883
is located to issue an injunction against any long-term care 2884
facility in violation of sections 3721.10 to 3721.17 of the 2885
Revised Code.2886

       (J) Any suspected violation of Chapter 3721. of the Revised 2887
Code discovered during the course of an investigation may be 2888
reported to the department of health. Any suspected criminal2889
violation discovered during the course of an investigation shall2890
be reported to the attorney general or other appropriate law2891
enforcement authorities.2892

       (K) The department of aging shall adopt rules in accordance 2893
with Chapter 119. of the Revised Code for referral by the state 2894
ombudsmanombudsperson and regional long-term care ombudsman2895
ombudsperson programs of complaints to other public agencies or 2896
entities. A public agency or entity to which a complaint is 2897
referred shall keep the state ombudsmanombudsperson or regional 2898
program handling the complaint advised and notified in writing in 2899
a timely manner of the disposition of the complaint to the extent 2900
permitted by law.2901

       Sec. 173.21.  (A) The office of the state long-term care2902
ombudsmanombudsperson program, through the state long-term care 2903
ombudsmanombudsperson and the regional long-term care ombudsman2904
ombudsperson programs, shall require each representative of the 2905
office to complete a training and certification program in 2906
accordance with this section and to meet the continuing education 2907
requirements established under this section.2908

       (B) The department of aging shall adopt rules under Chapter 2909
119. of the Revised Code specifying the content of training 2910
programs for representatives of the office of the state long-term 2911
care ombudsmanombudsperson program. Training for representatives2912
other than those who are volunteers providing services through2913
regional long-term care ombudsmanombudsperson programs shall 2914
include instruction regarding federal, state, and local laws, 2915
rules, and policies on long-term care facilities and 2916
community-based long-term care services; investigative techniques; 2917
and other topics considered relevant by the department and shall 2918
consist of the following:2919

       (1) A minimum of forty clock hours of basic instruction,2920
which shall be completed before the trainee is permitted to handle 2921
complaints without the supervision of a representative of the 2922
office certified under this section;2923

       (2) An additional sixty clock hours of instruction, which2924
shall be completed within the first fifteen months of employment;2925

       (3) An internship of twenty clock hours, which shall be2926
completed within the first twenty-four months of employment,2927
including instruction in, and observation of, basic nursing care2928
and long-term care provider operations and procedures. The2929
internship shall be performed at a site that has been approved as2930
an internship site by the state long-term care ombudsman2931
ombudsperson.2932

       (4) One of the following, which shall be completed within the 2933
first twenty-four months of employment:2934

       (a) Observation of a survey conducted by the director of2935
health to certify a facility to receive funds under sections2936
5111.205164.01 to 5111.325164.35 of the Revised Code;2937

       (b) Observation of an inspection conducted by the director of 2938
health to license an adult care facility under section 3722.04 of 2939
the Revised Code.2940

       (5) Any other training considered appropriate by the2941
department.2942

       (C) Persons who for a period of at least six months prior to 2943
June 11, 1990, served as ombudsmen through the long-term care2944
ombudsmanombudsperson program established by the department of 2945
aging under division (M) of section 173.01 of the Revised Code 2946
shall not be required to complete a training program. These 2947
persons and persons who complete a training program shall take an 2948
examination administered by the department of aging. On attainment 2949
of a passing score, the person shall be certified by the 2950
department as a representative of the office. The department shall 2951
issue the person an identification card, which the representative 2952
shall show at the request of any person with whom hethe2953
representative deals while performing histhe representative's2954
duties and which he shall surrenderbe surrendered at the time he2955
the representative separates from the office.2956

       (D) The state ombudsmanombudsperson and each regional 2957
program shall conduct training programs for volunteers on their 2958
respective staffs in accordance with the rules of the department 2959
of aging adopted under division (B) of this section. Training 2960
programs may be conducted that train volunteers to complete some, 2961
but not all, of the duties of a representative of the office. Each2962
regional office shall bear the cost of training its2963
representatives who are volunteers. On completion of a training2964
program, the representative shall take an examination administered 2965
by the department of aging. On attainment of a passing score, hea 2966
volunteer shall be certified by the department as a representative 2967
authorized to perform services specified in the certification. The 2968
department shall issue an identification card, which the 2969
representative shall show at the request of any person with whom 2970
hethe representative deals while performing histhe 2971
representative's duties and which he shall surrenderbe 2972
surrendered at the time hethe representative separates from the 2973
office. Except as a supervised part of a training program, no 2974
volunteer shall perform any duty unless he is certified as a 2975
representative having received appropriate training for that duty.2976

       (E) The state ombudsmanombudsperson shall provide technical2977
assistance to regional programs conducting training programs for 2978
volunteers and shall monitor the training programs.2979

       (F) Prior to scheduling an observation of a certification2980
survey or licensing inspection for purposes of division (B)(4) of2981
this section, the state ombudsmanombudsperson shall obtain 2982
permission to have the survey or inspection observed from both the 2983
director of health and the long-term care facility at which the 2984
survey or inspection is to take place.2985

       (G) The department of aging shall establish continuing2986
education requirements for representatives of the office.2987

       Sec. 173.26.  (A) Each of the following facilities shall2988
annually pay to the department of aging six dollars for each bed 2989
maintained by the facility for use by a resident during any part 2990
of the previous year:2991

       (1) Nursing homes, residential care facilities, and homes for 2992
the aging as defined in section 3721.01 of the Revised Code;2993

       (2) Facilities authorized to provide extended care services 2994
under Title XVIII of the "Social Security Act," 49 Stat. 620 2995
(1935), 42 U.S.C. 301, as amendedmedicare program;2996

       (3) County homes and district homes operated pursuant to2997
Chapter 5155. of the Revised Code;2998

       (4) Adult care facilities as defined in section 3722.01 of2999
the Revised Code;3000

       (5) Facilities approved by the Veterans Administration under 3001
Section 104(a) of the "Veterans Health Care Amendments of 1983," 3002
97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for 3003
the placement and care of veterans.3004

       The department shall, by rule adopted in accordance with 3005
Chapter 119. of the Revised Code, establish deadlines for payments 3006
required by this section. A facility that fails, within ninety 3007
days after the established deadline, to pay a payment required by 3008
this section shall be assessed at two times the original invoiced 3009
payment.3010

       (B) All money collected under this section shall be deposited 3011
in the state treasury to the credit of the office of the state 3012
long-term care ombudsperson program fund, which is hereby created. 3013
Money credited to the fund shall be used solely to pay the costs 3014
of operating the regional long-term care ombudsperson programs.3015

       (C) The state long-term care ombudsperson and the regional 3016
programs may solicit and receive contributions to support the3017
operation of the office or a regional program, except that no3018
contribution shall be solicited or accepted that would interfere3019
with the independence or objectivity of the office or program.3020

       Sec. 173.394.  (A) As used in this section:3021

       (1) "Applicant" means a person who is under final3022
consideration for employment with a community-based long-term care 3023
agency in a full-time, part-time, or temporary position that 3024
involves providing direct care to an individual. "Applicant" does 3025
not include a person who provides direct care as a volunteer 3026
without receiving or expecting to receive any form of remuneration3027
other than reimbursement for actual expenses.3028

       (2) "Criminal records check" has the same meaning as in3029
section 109.572 of the Revised Code.3030

       (B)(1) Except as provided in division (I) of this section, 3031
the chief administrator of a community-based long-term care agency3032
shall request that the superintendent of the bureau of criminal3033
identification and investigation conduct a criminal records check3034
with respect to each applicant. If an applicant for whom a 3035
criminal records check request is required under this division 3036
does not present proof of having been a resident of this state for 3037
the five-year period immediately prior to the date the criminal3038
records check is requested or provide evidence that within that3039
five-year period the superintendent has requested information3040
about the applicant from the federal bureau of investigation in a 3041
criminal records check, the chief administrator shall request that 3042
the superintendent obtain information from the federal bureau of3043
investigation as part of the criminal records check of the3044
applicant. Even if an applicant for whom a criminal records check 3045
request is required under this division presents proof of having 3046
been a resident of this state for the five-year period, the chief3047
administrator may request that the superintendent include3048
information from the federal bureau of investigation in the3049
criminal records check.3050

       (2) A person required by division (B)(1) of this section to 3051
request a criminal records check shall do both of the following:3052

       (a) Provide to each applicant for whom a criminal records 3053
check request is required under that division a copy of the form3054
prescribed pursuant to division (C)(1) of section 109.572 of the 3055
Revised Code and a standard fingerprint impression sheet 3056
prescribed pursuant to division (C)(2) of that section, and obtain 3057
the completed form and impression sheet from the applicant;3058

       (b) Forward the completed form and impression sheet to the3059
superintendent of the bureau of criminal identification and3060
investigation.3061

       (3) An applicant provided the form and fingerprint impression 3062
sheet under division (B)(2)(a) of this section who fails to 3063
complete the form or provide fingerprint impressions shall not be 3064
employed in any position for which a criminal records check is 3065
required by this section.3066

       (C)(1) Except as provided in rules adopted by the department3067
of aging in accordance with division (F) of this section and 3068
subject to division (C)(2) of this section, no community-based 3069
long-term care agency shall employ a person in a position that3070
involves providing direct care to an individual if the person has 3071
been convicted of or pleaded guilty to any of the following:3072

       (a) A violation of section 2903.01, 2903.02, 2903.03,3073
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,3074
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05, 3075
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 3076
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,3077
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 3078
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 3079
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 3080
2925.22, 2925.23, or 3716.11 of the Revised Code.3081

       (b) A violation of an existing or former law of this state,3082
any other state, or the United States that is substantially 3083
equivalent to any of the offenses listed in division (C)(1)(a) of 3084
this section.3085

       (2)(a) A community-based long-term care agency may employ 3086
conditionally an applicant for whom a criminal records check 3087
request is required under division (B) of this section prior to 3088
obtaining the results of a criminal records check regarding the 3089
individual, provided that the agency shall request a criminal3090
records check regarding the individual in accordance with division 3091
(B)(1) of this section not later than five business days after the 3092
individual begins conditional employment. In the circumstances 3093
described in division (I)(2) of this section, a community-based 3094
long-term care agency may employ conditionally an applicant who 3095
has been referred to the agency by an employment service that 3096
supplies full-time, part-time, or temporary staff for positions 3097
involving the direct care of individuals and for whom, pursuant to 3098
that division, a criminal records check is not required under 3099
division (B) of this section.3100

       (b) A community-based long-term care agency that employs an3101
individual conditionally under authority of division (C)(2)(a) of 3102
this section shall terminate the individual's employment if the3103
results of the criminal records check request under division (B)3104
of this section or described in division (I)(2) of this section,3105
other than the results of any request for information from the3106
federal bureau of investigation, are not obtained within the 3107
period ending sixty days after the date the request is made. 3108
Regardless of when the results of the criminal records check are 3109
obtained, if the results indicate that the individual has been 3110
convicted of or pleaded guilty to any of the offenses listed or 3111
described in division (C)(1) of this section, the agency shall 3112
terminate the individual's employment unless the agency chooses to 3113
employ the individual pursuant to division (F) of this section. 3114
Termination of employment under this division shall be considered 3115
just cause for discharge for purposes of division (D)(2) of 3116
section 4141.29 of the Revised Code if the individual makes any 3117
attempt to deceive the agency about the individual's criminal 3118
record.3119

       (D)(1) Each community-based long-term care agency shall pay 3120
to the bureau of criminal identification and investigation the fee 3121
prescribed pursuant to division (C)(3) of section 109.572 of the 3122
Revised Code for each criminal records check conducted pursuant to 3123
a request made under division (B) of this section.3124

       (2) A community-based long-term care agency may charge an 3125
applicant a fee not exceeding the amount the agency pays under 3126
division (D)(1) of this section. An agency may collect a fee only 3127
if both of the following apply:3128

       (a) The agency notifies the person at the time of initial3129
application for employment of the amount of the fee and that, 3130
unless the fee is paid, the person will not be considered for 3131
employment;3132

       (b) The medicaid program established under Chapter 5111. of 3133
the Revised Code does not reimburse the agency the fee it pays 3134
under division (D)(1) of this section.3135

       (E) The report of any criminal records check conducted3136
pursuant to a request made under this section is not a public3137
record for the purposes of section 149.43 of the Revised Code and3138
shall not be made available to any person other than the 3139
following:3140

       (1) The individual who is the subject of the criminal records 3141
check or the individual's representative;3142

       (2) The chief administrator of the agency requesting the 3143
criminal records check or the administrator's representative;3144

       (3) The administrator of any other facility, agency, or 3145
program that provides direct care to individuals that is owned or 3146
operated by the same entity that owns or operates the 3147
community-based long-term care agency;3148

       (4) The director of aging or a person authorized by the 3149
director to monitor a community-based long-term care agency's 3150
compliance with this section;3151

       (5) A court, hearing officer, or other necessary individual 3152
involved in a case dealing with a denial of employment of the 3153
applicant or dealing with employment or unemployment benefits of 3154
the applicant;3155

       (6) Any person to whom the report is provided pursuant to, 3156
and in accordance with, division (I)(1) or (2) of this section.3157

       (F) The department of aging shall adopt rules in accordance3158
with Chapter 119. of the Revised Code to implement this section. 3159
The rules shall specify circumstances under which a 3160
community-based long-term care agency may employ a person who has 3161
been convicted of or pleaded guilty to an offense listed or 3162
described in division (C)(1) of this section but meets personal 3163
character standards set by the department.3164

       (G) The chief administrator of a community-based long-term 3165
care agency shall inform each person, at the time of initial 3166
application for a position that involves providing direct care to 3167
an individual, that the person is required to provide a set of 3168
fingerprint impressions and that a criminal records check is 3169
required to be conducted if the person comes under final 3170
consideration for employment.3171

       (H) In a tort or other civil action for damages that is3172
brought as the result of an injury, death, or loss to person or3173
property caused by an individual who a community-based long-term 3174
care agency employs in a position that involves providing direct 3175
care to individuals, all of the following shall apply:3176

       (1) If the agency employed the individual in good faith and 3177
reasonable reliance on the report of a criminal records check 3178
requested under this section, the agency shall not be found 3179
negligent solely because of its reliance on the report, even if 3180
the information in the report is determined later to have been 3181
incomplete or inaccurate;3182

       (2) If the agency employed the individual in good faith on a 3183
conditional basis pursuant to division (C)(2) of this section, the3184
agency shall not be found negligent solely because it employed the 3185
individual prior to receiving the report of a criminal records 3186
check requested under this section;3187

       (3) If the agency in good faith employed the individual3188
according to the personal character standards established in rules 3189
adopted under division (F) of this section, the agency shall not 3190
be found negligent solely because the individual prior to being 3191
employed had been convicted of or pleaded guilty to an offense 3192
listed or described in division (C)(1) of this section.3193

       (I)(1) The chief administrator of a community-based 3194
long-term care agency is not required to request that the 3195
superintendent of the bureau of criminal identification and 3196
investigation conduct a criminal records check of an applicant if 3197
the applicant has been referred to the agency by an employment 3198
service that supplies full-time, part-time, or temporary staff for 3199
positions involving the direct care of individuals and both of the 3200
following apply:3201

       (a) The chief administrator receives from the employment3202
service or the applicant a report of the results of a criminal3203
records check regarding the applicant that has been conducted by3204
the superintendent within the one-year period immediately3205
preceding the applicant's referral;3206

       (b) The report of the criminal records check demonstrates3207
that the person has not been convicted of or pleaded guilty to an 3208
offense listed or described in division (C)(1) of this section, or 3209
the report demonstrates that the person has been convicted of or 3210
pleaded guilty to one or more of those offenses, but the 3211
community-based long-term care agency chooses to employ the 3212
individual pursuant to division (F) of this section.3213

       (2) The chief administrator of a community-based long-term 3214
care agency is not required to request that the superintendent of 3215
the bureau of criminal identification and investigation conduct a 3216
criminal records check of an applicant and may employ the 3217
applicant conditionally as described in this division, if the 3218
applicant has been referred to the agency by an employment service 3219
that supplies full-time, part-time, or temporary staff for 3220
positions involving the direct care of individuals and if the 3221
chief administrator receives from the employment service or the3222
applicant a letter from the employment service that is on the 3223
letterhead of the employment service, dated, and signed by a 3224
supervisor or another designated official of the employment 3225
service and that states that the employment service has requested 3226
the superintendent to conduct a criminal records check regarding 3227
the applicant, that the requested criminal records check will 3228
include a determination of whether the applicant has been 3229
convicted of or pleaded guilty to any offense listed or described 3230
in division (C)(1) of this section, that, as of the date set forth 3231
on the letter, the employment service had not received the results 3232
of the criminal records check, and that, when the employment 3233
service receives the results of the criminal records check, it 3234
promptly will send a copy of the results to the community-based 3235
long-term care agency. If a community-based long-term care agency 3236
employs an applicant conditionally in accordance with this 3237
division, the employment service, upon its receipt of the results 3238
of the criminal records check, promptly shall send a copy of the3239
results to the community-based long-term care agency, and division3240
(C)(2)(b) of this section applies regarding the conditional3241
employment.3242

       Sec. 173.40.  There is hereby created a medicaid waiver3243
component, as defined in section 5111.855163.50 of the Revised3244
Code, to be known as the preadmission screening system providing3245
options and resources today program, or PASSPORT. The PASSPORT3246
program shall provide home and community-based services as an3247
alternative to nursing facility placement for aged and disabled 3248
medicaid recipients. The program shall be operated pursuant to a3249
home and community-based waiver granted by the United States3250
secretary of health and human services under section 1915 of the3251
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 1396n, as3252
amended. The department of aging shall administer the program3253
through a contract entered into with the department of job and3254
family serviceshealth care administration under section 5111.913255
5161.05 of the Revised Code. The director of job and family 3256
serviceshealth care administration shall adopt rules under 3257
section 5111.855163.50 of the Revised Code and the director of 3258
aging shall adopt rules in accordance with Chapter 119. of the 3259
Revised Code to implement the program.3260

       Sec. 173.401.  (A) As used in this section:3261

       "Area agency on aging" has the same meaning as in section 3262
173.14 of the Revised Code.3263

       "Long-term care consultation program" means the program the 3264
department of aging is required to develop under section 173.42 of 3265
the Revised Code.3266

       "Long-term care consultation program administrator" or 3267
"administrator" means the department of aging or, if the 3268
department contracts with an area agency on aging or other entity 3269
to administer the long-term care consultation program for a 3270
particular area, that agency or entity.3271

       "Nursing facility" has the same meaning as in section 5111.203272
5164.01 of the Revised Code.3273

       "PASSPORT program" means the program created under section 3274
173.40 of the Revised Code.3275

       "PASSPORT waiver" means the federal medicaid waiver granted 3276
by the United States secretary of health and human services that 3277
authorizes the PASSPORT program.3278

       (B) The director of job and family serviceshealth care 3279
administration shall submit to the United States secretary of 3280
health and human services an amendment to the PASSPORT waiver 3281
that authorizes additional enrollments in the PASSPORT program 3282
pursuant to this section. Beginning with the month following the 3283
month in which the United States secretary approves the amendment 3284
and each month thereafter, each area agency on aging shall 3285
determine whether individuals who reside in the area that the 3286
area agency on aging serves and are on a waiting list for the 3287
PASSPORT program have been admitted to a nursing facility. If an 3288
area agency on aging determines that such an individual has been 3289
admitted to a nursing facility, the agency shall notify the 3290
long-term care consultation program administrator serving the 3291
area in which the individual resides about the determination. The 3292
administrator shall determine whether the PASSPORT program is 3293
appropriate for the individual and whether the individual would 3294
rather participate in the PASSPORT program than continue residing 3295
in the nursing facility. If the administrator determines that the 3296
PASSPORT program is appropriate for the individual and the 3297
individual would rather participate in the PASSPORT program than 3298
continue residing in the nursing facility, the administrator 3299
shall so notify the department of aging. On receipt of the notice 3300
from the administrator, the department of aging shall approve the 3301
individual's enrollment in the PASSPORT program regardless of the 3302
PASSPORT program's waiting list and even though the enrollment 3303
causes enrollment in the program to exceed the limit that would 3304
otherwise apply. Each quarter, the department of aging shall 3305
certify to the director of budget and management the estimated 3306
increase in costs of the PASSPORT program resulting from 3307
enrollment of individuals in the PASSPORT program pursuant to 3308
this section.3309

       (C) Not later than the last day of each calendar year, the 3310
director of job and family serviceshealth care administration3311
shall submit to the general assembly a report regarding the 3312
number of individuals enrolled in the PASSPORT program pursuant 3313
to this section and the costs incurred and savings achieved as a 3314
result of the enrollments.3315

       Sec. 173.42.  (A) As used in this section:3316

       (1) "Area agency on aging" means a public or private 3317
nonprofit entity designated under section 173.011 of the Revised 3318
Code to administer programs on behalf of the department of aging.3319

       (2) "Long-term care consultation" means the process used to 3320
provide services under the long-term care consultation program 3321
established pursuant to this section, including, but not limited 3322
to, such services as the provision of information about long-term 3323
care options and costs, the assessment of an individual's 3324
functional capabilities, and the conduct of all or part of the 3325
reviews, assessments, and determinations specified in sections 3326
5111.202, 5111.204, 5119.061, and 5123.021, 5164.45, and 5164.473327
of the Revised Code and the rules adopted under those sections.3328

       (3) "Medicaid" means the medical assistance program3329
established under Chapter 5111. of the Revised Code.3330

       (4) "Nursing facility" has the same meaning as in section3331
5111.205164.01 of the Revised Code.3332

       (5)(4) "Representative" means a person acting on behalf of an 3333
individual seeking a long-term care consultation, applying for 3334
admission to a nursing facility, or residing in a nursing 3335
facility. A representative may be a family member, attorney, 3336
hospital social worker, or any other person chosen to act on 3337
behalf of the individual.3338

       (B) The department of aging shall develop a long-term care 3339
consultation program whereby individuals or their representatives 3340
are provided with long-term care consultations and receive through 3341
these professional consultations information about options 3342
available to meet long-term care needs and information about 3343
factors to consider in making long-term care decisions. The 3344
long-term care consultations provided under the program may be 3345
provided at any appropriate time, as permitted or required under 3346
this section and the rules adopted under it, including either 3347
prior to or after the individual who is the subject of a 3348
consultation has been admitted to a nursing facility.3349

        (C) The long-term care consultation program shall be 3350
administered by the department of aging, except that the 3351
department may enter into a contract with an area agency on aging 3352
or other entity selected by the department under which the program 3353
for a particular area is administered by the area agency on aging 3354
or other entity pursuant to the contract.3355

        (D) The long-term care consultations provided for purposes of 3356
the program shall be provided by individuals certified by the 3357
department under section 173.43 of the Revised Code.3358

        (E) The information provided through a long-term care 3359
consultation shall be appropriate to the individual's needs and 3360
situation and shall address all of the following:3361

       (1) The availability of any long-term care options open to 3362
the individual;3363

       (2) Sources and methods of both public and private payment 3364
for long-term care services;3365

       (3) Factors to consider when choosing among the available 3366
programs, services, and benefits;3367

       (4) Opportunities and methods for maximizing independence and 3368
self-reliance, including support services provided by the 3369
individual's family, friends, and community.3370

       (F) An individual's long-term care consultation may include 3371
an assessment of the individual's functional capabilities. The 3372
consultation may incorporate portions of the determinations 3373
required under sections 5111.202, 5119.061, and 5123.021, and 3374
5164.45 of the Revised Code and may be provided concurrently with 3375
the assessment required under section 5111.2045164.47 of the 3376
Revised Code.3377

       (G)(1) Unless an exemption specified in division (I) of this 3378
section is applicable, each individual in the following categories 3379
shall be provided with a long-term care consultation:3380

       (a) Individuals who apply or indicate an intention to apply 3381
for admission to a nursing facility, regardless of the source of 3382
payment to be used for their care in a nursing facility;3383

       (b) Nursing facility residents who apply or indicate an 3384
intention to apply for medicaid;3385

       (c) Nursing facility residents who are likely to spend down 3386
their resources within six months after admission to a nursing 3387
facility to a level at which they are financially eligible for 3388
medicaid;3389

        (d) Individuals who request a long-term care consultation.3390

       (2) In addition to the individuals included in the categories 3391
specified in division (G)(1) of this section, long-term care 3392
consultations may be provided to nursing facility residents who 3393
have not applied and have not indicated an intention to apply for 3394
medicaid. The purpose of the consultations provided to these 3395
individuals shall be to determine continued need for nursing 3396
facility services, to provide information on alternative services, 3397
and to make referrals to alternative services.3398

       (H)(1) When a long-term care consultation is required to be 3399
provided pursuant to division (G)(1) of this section, the 3400
consultation shall be provided as follows or pursuant to division 3401
(H)(2) or (3) of this section:3402

       (a) If the individual for whom the consultation is being 3403
provided has applied for medicaid and the consultation is being 3404
provided concurrently with the assessment required under section 3405
5111.2045164.47 of the Revised Code, the consultation shall be 3406
completed in accordance with the applicable time frames specified 3407
in that section for providing a level of care determination based 3408
on the assessment.3409

       (b) In all other cases, the consultation shall be provided 3410
not later than five calendar days after the department or the 3411
program administrator under contract with the department receives 3412
notice of the reason for which the consultation is required to be 3413
provided pursuant to division (G)(1) of this section.3414

       (2) An individual or the individual's representative may 3415
request that a long-term care consultation be provided on a date 3416
that is later than the date required under division (H)(1)(a) or 3417
(b) of this section.3418

       (3) If a long-term care consultation cannot be completed 3419
within the number of days required by division (H)(1) or (2) of 3420
this section, the department or the program administrator under 3421
contract with the department may do any of the following:3422

       (a) Exempt the individual from the consultation pursuant to 3423
rules that may be adopted under division (L) of this section;3424

       (b) In the case of an applicant for admission to a nursing 3425
facility, provide the consultation after the individual is 3426
admitted to the nursing facility;3427

       (c) In the case of a resident of a nursing facility, provide 3428
the consultation as soon as practicable.3429

       (I) An individual is not required to be provided a long-term 3430
care consultation under this section if any of the following 3431
apply:3432

       (1) The individual or the individual's representative chooses 3433
to forego participation in the consultation pursuant to criteria 3434
specified in rules adopted under division (L) of this section;3435

       (2) The individual is to receive care in a nursing facility3436
under a contract for continuing care as defined in section 173.133437
of the Revised Code;3438

       (3) The individual has a contractual right to admission to a3439
nursing facility operated as part of a system of continuing care3440
in conjunction with one or more facilities that provide a less3441
intensive level of services, including a residential care facility3442
licensed under Chapter 3721. of the Revised Code, an adult care 3443
facility licensed under Chapter 3722. of the Revised Code, or an3444
independent living arrangement;3445

       (4) The individual is to receive continual care in a home for3446
the aged exempt from taxation under section 5701.13 of the Revised3447
Code;3448

       (5) The individual is seeking admission to a facility that is 3449
not a nursing facility with a provider agreement under section 3450
5111.225164.03 of the Revised Code;3451

       (6) The individual is to be transferred from another nursing3452
facility;3453

       (7) The individual is to be readmitted to a nursing facility3454
following a period of hospitalization;3455

       (8) The individual is exempted from the long-term care 3456
consultation requirement by the department or the program 3457
administrator pursuant to rules that may be adopted under division 3458
(L) of this section.3459

        (J) At the conclusion of an individual's long-term care 3460
consultation, the department or the program administrator under 3461
contract with the department shall provide the individual or 3462
individual's representative with a written summary of options and 3463
resources available to meet the individual's needs. Even though 3464
the summary may specify that a source of long-term care other than 3465
care in a nursing facility is appropriate and available, the 3466
individual is not required to seek an alternative source of 3467
long-term care and may be admitted to or continue to reside in a 3468
nursing facility.3469

       (K) No nursing facility for which an operator has a provider 3470
agreement under section 5111.225164.03 of the Revised Code shall3471
admit or retain any individual as a resident, unless the nursing 3472
facility has received evidence that a long-term care consultation 3473
has been completed for the individual or division (I) of this 3474
section is applicable to the individual.3475

       (L) The director of aging may adopt any rules the director 3476
considers necessary for the implementation and administration of 3477
this section. The rules shall be adopted in accordance with 3478
Chapter 119. of the Revised Code and may specify any or all of the 3479
following:3480

       (1) Procedures for providing long-term care consultations 3481
pursuant to this section;3482

       (2) Information to be provided through long-term care 3483
consultations regarding long-term care services that are 3484
available;3485

       (3) Criteria under which an individual or the individual's 3486
representative may choose to forego participation in a long-term 3487
care consultation;3488

       (4) Criteria for exempting individuals from the long-term 3489
care consultation requirement;3490

       (5) Circumstances under which it may be appropriate to 3491
provide an individual's long-term care consultation after the 3492
individual's admission to a nursing facility rather than before 3493
admission;3494

        (6) Criteria for identifying nursing facility residents who 3495
would benefit from the provision of a long-term care consultation.3496

       (M) The director of aging may fine a nursing facility an 3497
amount determined by rules the director shall adopt in accordance 3498
with Chapter 119. of the Revised Code if the nursing facility 3499
admits or retains an individual, without evidence that a long-term 3500
care consultation has been provided, as required by this section.3501

        In accordance with section 5111.625164.78 of the Revised 3502
Code, all fines collected under this division shall be deposited 3503
into the state treasury to the credit of the residents protection 3504
fund.3505

       Sec. 173.45. As used in this section and in sections 173.46 3506
to 173.49 of the Revised Code:3507

        (A) "Long-term care facility" means a nursing home or 3508
residential care facility.3509

        (B) "Nursing home" and "residential care facility" have the 3510
same meanings as in section 3721.01 of the Revised Code.3511

        (C) "Nursing facility" has the same meaning as in section 3512
5111.205164.01 of the Revised Code.3513

       Sec. 173.47. (A) For purposes of publishing the Ohio 3514
long-term care consumer guide, the department of aging shall 3515
conduct or provide for the conduct of an annual customer 3516
satisfaction survey of each long-term care facility. The results 3517
of the surveys may include information obtained from long-term 3518
care facility residents, their families, or both.3519

        (B)(1) The department may charge fees for the conduct of 3520
annual customer satisfaction surveys. The department may contract 3521
with any person or government entity to collect the fees on its 3522
behalf. All fees collected under this section shall be deposited 3523
in accordance with section 173.48 of the Revised Code.3524

        (2) The fees charged under this section shall not exceed the 3525
following amounts:3526

        (a) Four hundred dollars for the customer satisfaction survey 3527
of a long-term care facility that is a nursing home;3528

        (b) Three hundred dollars for the customer satisfaction 3529
survey pertaining to a long-term care facility that is a 3530
residential care facility.3531

        (3) Fees paid by a long-term care facility that is a nursing 3532
facility shall be reimbursed through the medicaid program operated 3533
under Chapter 5111. of the Revised Code.3534

       (C) Each long-term care facility shall cooperate in the 3535
conduct of its annual customer satisfaction survey.3536

       Sec. 173.50. (A) Pursuant to a contract entered into with the 3537
department of job and family serviceshealth care administration3538
as an interagency agreement under section 5111.915161.05 of the 3539
Revised Code, the department of aging shall carry out the 3540
day-to-day administration of the component of the medicaid program 3541
established under Chapter 5111. of the Revised Code known as the 3542
program of all-inclusive care for the elderly or PACE. The 3543
department of aging shall carry out its PACE administrative duties 3544
in accordance with the provisions of the interagency agreement and 3545
all applicable federal laws, including the "Social Security Act," 3546
79 Stat. 286 (1965), 42 U.S.C. 1396u-4, as amended.3547

       (B) The department of aging may adopt rules in accordance 3548
with Chapter 119. of the Revised Code regarding the PACE program, 3549
subject to both of the following:3550

        (1) The rules shall be authorized by rules adopted by the 3551
department of job and family services.3552

        (2) The rules shall address only those issues that are not 3553
addressed in rules adopted by the department of job and family 3554
services for the PACE program.3555

       Sec. 173.99.  (A) A long-term care provider, person employed 3556
by a long-term care provider, other entity, or employee of such 3557
other entity that violates division (C) of section 173.24 of the 3558
Revised Code is subject to a fine not to exceed one thousand 3559
dollars for each violation.3560

       (B) Whoever violates division (C) of section 173.23 of the 3561
Revised Code is guilty of registering a false complaint, a 3562
misdemeanor of the first degree.3563

       (C) A long-term care provider, other entity, or person 3564
employed by a long-term care provider or other entity that 3565
violates division (E) of section 173.19 of the Revised Code by 3566
denying a representative of the office of the state long-term care 3567
ombudsperson program the access required by that division is 3568
subject to a fine not to exceed five hundred dollars for each 3569
violation.3570

       (D) Whoever violates division (C) of section 173.44 of the 3571
Revised Code is subject to a fine of one hundred dollars.3572

       (E) Whoever violates division (B) of section 173.90 of the 3573
Revised Code is guilty of a misdemeanor of the first degree.3574

       Sec. 317.08. (A) Except as provided in divisions (C) and (D) 3575
of this section, the county recorder shall keep six separate sets3576
of records as follows:3577

       (1) A record of deeds, in which shall be recorded all deeds3578
and other instruments of writing for the absolute and3579
unconditional sale or conveyance of lands, tenements, and3580
hereditaments; all notices as provided in sections 5301.47 to3581
5301.56 of the Revised Code; all judgments or decrees in actions3582
brought under section 5303.01 of the Revised Code; all3583
declarations and bylaws, and all amendments to declarations and3584
bylaws, as provided in Chapter 5311. of the Revised Code;3585
affidavits as provided in sections 5301.252 and 5301.56 of the 3586
Revised Code; all certificates as provided in section 5311.17 of 3587
the Revised Code; all articles dedicating archaeological preserves3588
accepted by the director of the Ohio historical society under3589
section 149.52 of the Revised Code; all articles dedicating nature3590
preserves accepted by the director of natural resources under3591
section 1517.05 of the Revised Code; all agreements for the3592
registration of lands as archaeological or historic landmarks3593
under section 149.51 or 149.55 of the Revised Code; all3594
conveyances of conservation easements and agricultural easements3595
under section 5301.68 of the Revised Code; all instruments3596
extinguishing agricultural easements under section 901.21 or3597
5301.691 of the Revised Code or pursuant to terms of such an3598
easement granted to a charitable organization under section3599
5301.68 of the Revised Code; all instruments or orders described3600
in division (B)(2)(b) of section 5301.56 of the Revised Code; all 3601
no further action letters issued under section 122.654 or 3746.11 3602
of the Revised Code; all covenants not to sue issued under section3603
3746.12 of the Revised Code, including all covenants not to sue 3604
issued pursuant to section 122.654 of the Revised Code; any3605
restrictions on the use of property contained in a no further3606
action letter issued under section 122.654 of the Revised Code,3607
any restrictions on the use of property identified pursuant to3608
division (C)(3)(a) of section 3746.10 of the Revised Code, and any 3609
restrictions on the use of property contained in a deed or other 3610
instrument as provided in division (E) or (F) of section 3737.882 3611
of the Revised Code; any easement executed or granted under 3612
section 3734.22, 3734.24, 3734.25, or 3734.26 of the Revised Code; 3613
any environmental covenant entered into in accordance with 3614
sections 5301.80 to 5301.92 of the Revised Code; all memoranda of 3615
trust, as described in division (A) of section 5301.255 of the 3616
Revised Code, that describe specific real property; and all 3617
agreements entered into under division (A) of section 1506.44 of3618
the Revised Code;3619

       (2) A record of mortgages, in which shall be recorded all of3620
the following:3621

       (a) All mortgages, including amendments, supplements,3622
modifications, and extensions of mortgages, or other instruments3623
of writing by which lands, tenements, or hereditaments are or may3624
be mortgaged or otherwise conditionally sold, conveyed, affected,3625
or encumbered;3626

       (b) All executory installment contracts for the sale of land3627
executed after September 29, 1961, that by their terms are not3628
required to be fully performed by one or more of the parties to3629
them within one year of the date of the contracts;3630

       (c) All options to purchase real estate, including3631
supplements, modifications, and amendments of the options, but no3632
option of that nature shall be recorded if it does not state a3633
specific day and year of expiration of its validity;3634

       (d) Any tax certificate sold under section 5721.33 of the3635
Revised Code, or memorandum of it, that is presented for filing of 3636
record.3637

       (3) A record of powers of attorney, including all memoranda3638
of trust, as described in division (A) of section 5301.255 of the3639
Revised Code, that do not describe specific real property;3640

       (4) A record of plats, in which shall be recorded all plats3641
and maps of town lots, of the subdivision of town lots, and of3642
other divisions or surveys of lands, any center line survey of a3643
highway located within the county, the plat of which shall be3644
furnished by the director of transportation or county engineer,3645
and all drawings and amendments to drawings, as provided in3646
Chapter 5311. of the Revised Code;3647

       (5) A record of leases, in which shall be recorded all3648
leases, memoranda of leases, and supplements, modifications, and3649
amendments of leases and memoranda of leases;3650

       (6) A record of declarations executed pursuant to section3651
2133.02 of the Revised Code and durable powers of attorney for3652
health care executed pursuant to section 1337.12 of the Revised3653
Code.3654

       (B) All instruments or memoranda of instruments entitled to3655
record shall be recorded in the proper record in the order in3656
which they are presented for record. The recorder may index, keep, 3657
and record in one volume unemployment compensation liens, internal 3658
revenue tax liens and other liens in favor of the United States as 3659
described in division (A) of section 317.09 of the Revised Code, 3660
personal tax liens, mechanic's liens, agricultural product liens, 3661
notices of liens, certificates of satisfaction or partial release 3662
of estate tax liens, discharges of recognizances, excise and 3663
franchise tax liens on corporations, broker's liens, and liens3664
provided for in sections 1513.33, 1513.37, 3752.13, 5111.0223665
5163.08, and 5311.18 of the Revised Code.3666

       The recording of an option to purchase real estate, including3667
any supplement, modification, and amendment of the option, under3668
this section shall serve as notice to any purchaser of an interest3669
in the real estate covered by the option only during the period of3670
the validity of the option as stated in the option.3671

       (C) In lieu of keeping the six separate sets of records3672
required in divisions (A)(1) to (6) of this section and the3673
records required in division (D) of this section, a county3674
recorder may record all the instruments required to be recorded by3675
this section in two separate sets of record books. One set shall3676
be called the "official records" and shall contain the instruments3677
listed in divisions (A)(1), (2), (3), (5), and (6) and (D) of this 3678
section. The second set of records shall contain the instruments 3679
listed in division (A)(4) of this section.3680

       (D) Except as provided in division (C) of this section, the3681
county recorder shall keep a separate set of records containing3682
all corrupt activity lien notices filed with the recorder pursuant3683
to section 2923.36 of the Revised Code and a separate set of3684
records containing all medicaid fraud lien notices filed with the3685
recorder pursuant to section 2933.75 of the Revised Code.3686

       Sec. 317.36. (A) The county recorder shall collect the low- 3687
and moderate-income housing trust fund fee as specified in 3688
sections 317.114, 317.32, 1563.42, 1702.59, 2505.13, 4141.23, 3689
4509.60, 5111.0225163.08, 5310.15, 5719.07, 5727.56, 5733.18, 3690
5733.22, 6101.09, and 6115.09 of the Revised Code. The amount of 3691
any housing trust fund fee the recorder is authorized to collect 3692
is equal to the amount of any base fee the recorder is authorized 3693
to collect for services. The housing trust fund fee shall be 3694
collected in addition to the base fee.3695

       (B) The recorder shall certify the amounts collected as 3696
housing trust fund fees pursuant to division (A) of this section 3697
into the county treasury as housing trust fund fees to be paid to 3698
the treasurer of state pursuant to section 319.63 of the Revised 3699
Code.3700

       Sec. 323.01.  Except as otherwise provided, as used in3701
Chapter 323. of the Revised Code:3702

       (A) "Subdivision" means any county, township, school3703
district, or municipal corporation.3704

       (B) "Municipal corporation" includes charter municipalities.3705

       (C) "Taxes" means the total amount of all charges against an 3706
entry appearing on a tax list and the duplicate thereof that was 3707
prepared and certified in accordance with section 319.28 of the 3708
Revised Code, including taxes levied against real estate; taxes on 3709
property whose value is certified pursuant to section 5727.23 of 3710
the Revised Code; recoupment charges applied pursuant to section 3711
5713.35 of the Revised Code; all assessments; penalties and 3712
interest charged pursuant to section 323.121 of the Revised Code; 3713
charges added pursuant to section 319.35 of the Revised Code; and 3714
all of such charges which remain unpaid from any previous tax 3715
year.3716

       (D) "Current taxes" means all taxes charged against an entry 3717
on the general tax list and duplicate of real and public utility 3718
property that have not appeared on such list and duplicate for any 3719
prior tax year and any penalty thereon charged by division (A) of 3720
section 323.121 of the Revised Code. Current taxes, whether or not 3721
they have been certified delinquent, become delinquent taxes if 3722
they remain unpaid after the last day prescribed for payment of 3723
the second installment of current taxes without penalty.3724

       (E) "Delinquent taxes" means:3725

       (1) Any taxes charged against an entry on the general tax3726
list and duplicate of real and public utility property that were3727
charged against an entry on such list and duplicate for a prior3728
tax year and any penalties and interest charged against such3729
taxes.3730

       (2) Any current taxes charged on the general tax list and3731
duplicate of real and public utility property that remain unpaid3732
after the last day prescribed for payment of the second3733
installment of such taxes without penalty, whether or not they3734
have been certified delinquent, and any penalties and interest3735
charged against such taxes.3736

       (F) "Current tax year" means, with respect to particular3737
taxes, the calendar year in which the first installment of taxes3738
is due prior to any extension granted under section 323.17 of the3739
Revised Code.3740

       (G) "Liquidated claim" means:3741

       (1) Any sum of money due and payable, upon a written3742
contractual obligation executed between the subdivision and the3743
taxpayer, but excluding any amount due on general and special3744
assessment bonds and notes;3745

       (2) Any sum of money due and payable, for disability 3746
financial assistance or disability medical assistance provided 3747
under Chapter 5115. of the Revised Code or the disability medical 3748
assistance program that is furnished to or in behalf of a 3749
subdivision, provided that such claim is recognized by a3750
resolution or ordinance of the legislative body of such3751
subdivision;3752

       (3) Any sum of money advanced and paid to or received and3753
used by a subdivision, pursuant to a resolution or ordinance of3754
such subdivision or its predecessor in interest, and the moral3755
obligation to repay which sum, when in funds, shall be recognized3756
by resolution or ordinance by the subdivision.3757

       Sec. 329.04.  (A) The county department of job and family3758
services shall have, exercise, and perform the following powers3759
and duties:3760

       (1) Perform any duties assigned by the state department of3761
job and family services regarding the provision of public family3762
services, including the provision of the following services to3763
prevent or reduce economic or personal dependency and to3764
strengthen family life:3765

       (a) Services authorized by a Title IV-A program, as defined 3766
in section 5101.80 of the Revised Code;3767

       (b) Social services authorized by Title XX of the "Social3768
Security Act" and provided for by section 5101.46 or 5101.461 of 3769
the Revised Code;3770

       (c) If the county department is designated as the child3771
support enforcement agency, services authorized by Title IV-D of3772
the "Social Security Act" and provided for by Chapter 3125. of3773
the Revised Code. The county department may perform the services3774
itself or contract with other government entities, and, pursuant3775
to division (C) of section 2301.35 and section 2301.42 of the3776
Revised Code, private entities, to perform the Title IV-D3777
services.3778

       (d) Duties assigned under section 5111.985161.02 of the 3779
Revised Code.3780

       (2) Administer disability financial assistance, as required 3781
by the state department of job and family services under section 3782
5115.03 of the Revised Code;3783

       (3) Administer disability medical assistance program, as 3784
required by the state department of job and family services under 3785
section 5115.13 of the Revised Codehealth care administration;3786

       (4) Administer burials insofar as the administration of3787
burials was, prior to September 12, 1947, imposed upon the board3788
of county commissioners and if otherwise required by state law;3789

       (5) Cooperate with state and federal authorities in any3790
matter relating to family services and to act as the agent of such3791
authorities;3792

       (6) Submit an annual account of its work and expenses to the3793
board of county commissioners and to the state department of job3794
and family services at the close of each fiscal year;3795

       (7) Exercise any powers and duties relating to family3796
services duties or workforce development activities imposed upon 3797
the county department of job and family services by law, by 3798
resolution of the board of county commissioners, or by order of 3799
the governor, when authorized by law, to meet emergencies during 3800
war or peace;3801

       (8) Determine theMake eligibility determinations for medical 3802
assistance of recipients of aid under Title XVI of the "Social 3803
Security Act"the medicaid program in accordance with rules 3804
adopted under section 5162.20 of the Revised Code;3805

       (9) If assigned by the state director of job and family3806
serviceshealth care administration under section 5101.5155167.153807
or 5101.5255167.26 of the Revised Code, determine applicants' 3808
eligibility for health assistance under the children's health 3809
insurance program part II or part III;3810

       (10) Enter into a plan of cooperation with the board of3811
county commissioners under section 307.983, consult with the board3812
in the development of the transportation work plan developed under3813
section 307.985, establish with the board procedures under section3814
307.986 for providing services to children whose families relocate3815
frequently, and comply with the contracts the board enters into3816
under sections 307.981 and 307.982 of the Revised Code that affect3817
the county department;3818

       (11) For the purpose of complying with a grant agreement the 3819
board of county commissioners enters into under sections 307.98 3820
and 5101.21 of the Revised Code, exercise the powers and perform 3821
the duties the grant agreement assigns to the county department;3822

       (12) If the county department is designated as the workforce3823
development agency, provide the workforce development activities3824
specified in the contract required by section 330.05 of the3825
Revised Code.3826

       (B) The powers and duties of a county department of job and3827
family services are, and shall be exercised and performed, under3828
the control and direction of the board of county commissioners.3829
The board may assign to the county department any power or duty of3830
the board regarding family services duties and workforce 3831
development activities. If the new power or duty necessitates the 3832
state department of job and family services changing its federal 3833
cost allocation plan, the county department may not implement the 3834
power or duty unless the United States department of health and 3835
human services approves the changes.3836

       Sec. 329.043. With regard to applicants for and recipients of 3837
disability financial assistance or disability medical assistance, 3838
each county department of job and family services shall do all of 3839
the following:3840

       (A) Identify applicants and recipients who might be eligible 3841
for benefits under the supplemental security income program;3842

       (B) Assist applicants and recipients in securing 3843
documentation of disabling conditions or refer them for such 3844
assistance to a person or government entity with which the 3845
department of job and family services or county department has 3846
contracted under section 5115.20 of the Revised Code;3847

       (C) Inform applicants and recipients of available sources of 3848
representation, which may include a person or government entity 3849
with which the department of job and family services or county 3850
department has contracted under section 5115.20 of the Revised 3851
Code, and of their right to represent themselves in 3852
reconsiderations and appeals of social security administration 3853
decisions that deny them supplemental security income benefits. 3854
The county department may require the applicants and recipients, 3855
as a condition of eligibility for disability financial assistance 3856
or disability medical assistance, to pursue reconsiderations and 3857
appeals of social security administration decisions that deny them 3858
supplemental security income benefits, and shall assist applicants 3859
and recipients as necessary to obtain such benefits or refer them 3860
to a person or government entity with which the department or 3861
county department has contracted under section 5115.20 of the 3862
Revised Code.3863

       (D) Require applicants and recipients who, in the judgment of 3864
the county department, are or may be aged, blind, or disabled, to 3865
apply for the medicaid program, make determinations when 3866
appropriate as to eligibility for medicaid, and refer their 3867
applications when necessary to the disability determination unit 3868
established in accordance with section 5162.17 of the Revised Code 3869
for expedited review;3870

       (E) Require each applicant and recipient who in the judgment 3871
of the department of job and family services or the county 3872
department might be eligible for supplemental security income 3873
benefits, as a condition of eligibility for disability financial 3874
assistance or disability medical assistance, to execute a written 3875
authorization for the secretary of health and human services to 3876
withhold benefits due that individual and pay to the director of 3877
job and family services, director of health care administration, 3878
or either director's designee an amount sufficient to reimburse 3879
the state and county shares of interim assistance furnished to the 3880
individual. For the purposes of this division, "benefits" and 3881
"interim assistance" have the meanings given in Title XVI of the 3882
"Social Security Act of 1935."3883

       Sec. 329.051.  The county department of job and family3884
services shall make voter registration applications as prescribed 3885
by the secretary of state under section 3503.10 of the Revised 3886
Code available to persons who are applying for, receiving 3887
assistance from, or participating in any of the following:3888

       (A) The disability financial assistance program established 3889
under Chapter 5115. of the Revised Code;3890

       (B) The disability medical assistance program established 3891
under Chapter 5115. of the Revised Code;3892

       (C) The medical assistancemedicaid program established under3893
Chapter 5111. of the Revised Code;3894

       (D) The Ohio works first program established under Chapter 3895
5107. of the Revised Code;3896

       (E) The prevention, retention, and contingency program3897
established under Chapter 5108. of the Revised Code.3898

       Sec. 329.06.  (A) Except as provided in division (C) of this 3899
section and section 6301.08 of the Revised Code, the board of 3900
county commissioners shall establish a county family services 3901
planning committee. The board shall appoint a member to represent 3902
the county department of job and family services; an employee in 3903
the classified civil service of the county department of job and 3904
family services, if there are any such employees; and a member to 3905
represent the public. The board shall appoint other individuals to 3906
the committee in such a manner that the committee's membership is 3907
broadly representative of the groups of individuals and the public 3908
and private entities that have an interest in the family services 3909
provided in the county. The board shall make appointments in a 3910
manner that reflects the ethnic and racial composition of the 3911
county. The following groups and entities may be represented on 3912
the committee:3913

       (1) Consumers of family services;3914

       (2) The public children services agency;3915

       (3) The child support enforcement agency;3916

       (4) The county family and children first council;3917

       (5) Public and private colleges and universities;3918

       (6) Public entities that provide family services, including 3919
boards of health, boards of education, the county board of mental 3920
retardation and developmental disabilities, and the board of 3921
alcohol, drug addiction, and mental health services that serves 3922
the county;3923

       (7) Private nonprofit and for-profit entities that provide 3924
family services in the county or that advocate for consumers of 3925
family services in the county, including entities that provide3926
services to or advocate for victims of domestic violence;3927

       (8) Labor organizations;3928

       (9) Any other group or entity that has an interest in the3929
family services provided in the county, including groups or3930
entities that represent any of the county's business, urban, and3931
rural sectors.3932

       (B) The county family services planning committee shall do 3933
all of the following:3934

       (1) Serve as an advisory body to the board of county3935
commissioners with regard to the family services provided in the3936
county, including assistance under Chapters 5107. and 5108. of the3937
Revised Code, publicly funded child care under Chapter 5104. of3938
the Revised Code, and social services provided under section 3939
5101.46 of the Revised Code;3940

       (2) At least once a year, review and analyze the county 3941
department of job and family services' implementation of the 3942
programs established under Chapters 5107. and 5108. of the Revised 3943
Code. In its review, the committee shall use information available 3944
to it to examine all of the following:3945

       (a) Return of assistance groups to participation in either 3946
program after ceasing to participate;3947

       (b) Teen pregnancy rates among the programs' participants;3948

       (c) The other types of assistance the programs' participants3949
receive, including medical assistance under Chapter 5111. of the3950
Revised Codemedicaid, publicly funded child care under Chapter 3951
5104. of the Revised Code, food stamp benefits under section 3952
5101.54 of the Revised Code, and energy assistance under Chapter 3953
5117. of the Revised Code;3954

       (d) Other issues the committee considers appropriate.3955

       The committee shall make recommendations to the board of 3956
county commissioners and county department of job and family3957
services regarding the committee's findings.3958

       (3) Conduct public hearings on proposed county profiles for 3959
the provision of social services under section 5101.46 of the3960
Revised Code;3961

       (4) At the request of the board, make recommendations and3962
provide assistance regarding the family services provided in the3963
county;3964

       (5) At any other time the committee considers appropriate, 3965
consult with the board and make recommendations regarding the 3966
family services provided in the county. The committee's 3967
recommendations may address the following:3968

       (a) Implementation and administration of family service 3969
programs;3970

       (b) Use of federal, state, and local funds available for 3971
family service programs;3972

       (c) Establishment of goals to be achieved by family service 3973
programs;3974

       (d) Evaluation of the outcomes of family service programs;3975

       (e) Any other matter the board considers relevant to the 3976
provision of family services.3977

       (C) If there is a committee in existence in a county on 3978
October 1, 1997, that the board of county commissioners determines 3979
is capable of fulfilling the responsibilities of a county family3980
services planning committee, the board may designate the committee 3981
as the county's family services planning committee and the 3982
committee shall serve in that capacity.3983

       Sec. 329.14.  (A) An individual whose household income does 3984
not exceed two hundred per cent of the federal poverty line is 3985
eligible to participate in an individual development account 3986
program established by the county department of job and family 3987
services of the county in which the individual resides. An 3988
eligible individual seeking to be a participant in the program 3989
shall enter into an agreement with the fiduciary organization 3990
administering the program. The agreement shall specify the terms 3991
and conditions of uses of funds deposited, financial documentation3992
required to be maintained by the participant, expectations and3993
responsibilities of the participant, and services to be provided 3994
by the fiduciary organization.3995

       (B) A participant may deposit earned income, as defined in 26 3996
U.S.C. 911(d)(2), as amended, into the account. The fiduciary3997
organization may deposit into the account an amount not exceeding 3998
four times the amount deposited by the participant except that a 3999
fiduciary organization may not, pursuant to an agreement with an 4000
employer, deposit an amount into an account held by a participant 4001
who is employed by the employer. An account may have no more than 4002
ten thousand dollars in it at any time.4003

       (C) Notwithstanding eligibility requirements established in 4004
or pursuant to Chapter 5107.,or 5108., or 5111. of the Revised4005
Code or for the medicaid program, to the extent permitted by 4006
federal statutes and regulations, money in an individual 4007
development account, including interest, is exempt from 4008
consideration in determining whether the participant or a member 4009
of the participant's assistance group is eligible for assistance 4010
under Chapter 5107.,or 5108., or 5111. of the Revised Code or the 4011
medicaid program and the amount of assistance the participant or 4012
assistance group is eligible to receive.4013

       (D)(1) Except as provided in division (D)(2) of this section, 4014
an individual development account program participant may use 4015
money in the account only for the following purposes:4016

       (a) Postsecondary educational expenses paid directly from the 4017
account to an eligible education institution or vendor;4018

       (b) Qualified acquisition expenses of a principal residence, 4019
as defined in 26 U.S.C. 1034, as amended, paid directly from the4020
account to the person or government entity to which the expenses 4021
are due;4022

       (c) Qualified business capitalization expenses made in4023
accordance with a qualified business plan that has been approved 4024
by a financial institution or by a nonprofit microenterprise 4025
program having demonstrated business expertise and paid directly4026
from the account to the person to whom the expenses are due.4027

       (2) A fiduciary organization shall permit a participant to 4028
withdraw money deposited by the participant if it is needed to 4029
deal with a personal emergency of the participant or a member of 4030
the participant's family or household. Withdrawal shall result in 4031
the loss of any matching funds in an amount equal to the amount of 4032
the withdrawal.4033

       (3) Regardless of the reason for the withdrawal, a withdrawal 4034
from an individual development account may be made only with the 4035
approval of the fiduciary organization.4036

       Sec. 340.03.  (A) Subject to rules issued by the director of4037
mental health after consultation with relevant constituencies as4038
required by division (A)(11) of section 5119.06 of the Revised4039
Code, with regard to mental health services, the board of alcohol,4040
drug addiction, and mental health services shall:4041

       (1) Serve as the community mental health planning agency for4042
the county or counties under its jurisdiction, and in so doing it4043
shall:4044

       (a) Evaluate the need for facilities and community mental4045
health services;4046

       (b) In cooperation with other local and regional planning and 4047
funding bodies and with relevant ethnic organizations, assess the 4048
community mental health needs, set priorities, and develop plans 4049
for the operation of facilities and community mental health4050
services;4051

       (c) In accordance with guidelines issued by the director of4052
mental health after consultation with board representatives,4053
develop and submit to the department of mental health, no later4054
than six months prior to the conclusion of the fiscal year in4055
which the board's current plan is scheduled to expire, a community4056
mental health plan listing community mental health needs,4057
including the needs of all residents of the district now residing4058
in state mental institutions and severely mentally disabled4059
adults, children, and adolescents; all children subject to a4060
determination made pursuant to section 121.38 of the Revised Code;4061
and all the facilities and community mental health services that4062
are or will be in operation or provided during the period for4063
which the plan will be in operation in the service district to4064
meet such needs.4065

       The plan shall include, but not be limited to, a statement of4066
which of the services listed in section 340.09 of the Revised Code4067
the board intends to make available. The board must include crisis 4068
intervention services for individuals in an emergency situation in 4069
the plan and explain how the board intends to make such services 4070
available. The plan must also include an explanation of how the 4071
board intends to make any payments that it may be required to pay 4072
under section 5119.62 of the Revised Code, a statement of the4073
inpatient and community-based services the board proposes that the4074
department operate, an assessment of the number and types of4075
residential facilities needed, such other information as the4076
department requests, and a budget for moneys the board expects to4077
receive. The board shall also submit an allocation request for4078
state and federal funds. Within sixty days after the department's4079
determination that the plan and allocation request are complete,4080
the department shall approve or disapprove the plan and request,4081
in whole or in part, according to the criteria developed pursuant4082
to section 5119.61 of the Revised Code. The department's statement 4083
of approval or disapproval shall specify the inpatient and the 4084
community-based services that the department will operate for the 4085
board. Eligibility for state and federal funding shall be4086
contingent upon an approved plan or relevant part of a plan. 4087

       If the director disapproves all or part of any plan, the4088
director shall inform the board of the reasons for the disapproval4089
and of the criteria that must be met before the plan may be4090
approved. The director shall provide the board an opportunity to4091
present its case on behalf of the plan. The director shall give4092
the board a reasonable time in which to meet the criteria, and4093
shall offer the board technical assistance to help it meet the4094
criteria.4095

       If the approval of a plan remains in dispute thirty days4096
prior to the conclusion of the fiscal year in which the board's4097
current plan is scheduled to expire, the board or the director may4098
request that the dispute be submitted to a mutually agreed upon4099
third-party mediator with the cost to be shared by the board and4100
the department. The mediator shall issue to the board and the4101
department recommendations for resolution of the dispute. Prior to4102
the conclusion of the fiscal year in which the current plan is4103
scheduled to expire, the director, taking into consideration the4104
recommendations of the mediator, shall make a final determination4105
and approve or disapprove the plan, in whole or in part.4106

       If a board determines that it is necessary to amend a plan or4107
an allocation request that has been approved under division4108
(A)(1)(c) of this section, the board shall submit a proposed4109
amendment to the director. The director may approve or disapprove4110
all or part of the amendment. If the director does not approve all 4111
or part of the amendment within thirty days after it is submitted, 4112
the amendment or part of it shall be considered to have been 4113
approved. The director shall inform the board of the reasons for4114
disapproval of all or part of an amendment and of the criteria4115
that must be met before the amendment may be approved. The4116
director shall provide the board an opportunity to present its4117
case on behalf of the amendment. The director shall give the board 4118
a reasonable time in which to meet the criteria, and shall offer 4119
the board technical assistance to help it meet the criteria.4120

       The board shall implement the plan approved by the4121
department.4122

       (d) Receive, compile, and transmit to the department of4123
mental health applications for state reimbursement;4124

       (e) Promote, arrange, and implement working agreements with4125
social agencies, both public and private, and with judicial4126
agencies.4127

       (2) Investigate, or request another agency to investigate,4128
any complaint alleging abuse or neglect of any person receiving4129
services from a community mental health agency as defined in4130
section 5122.01 of the Revised Code, or from a residential4131
facility licensed under section 5119.22 of the Revised Code. If4132
the investigation substantiates the charge of abuse or neglect,4133
the board shall take whatever action it determines is necessary to4134
correct the situation, including notification of the appropriate4135
authorities. Upon request, the board shall provide information4136
about such investigations to the department.4137

       (3) For the purpose of section 5119.611 of the Revised Code,4138
cooperate with the director of mental health in visiting and4139
evaluating whether the services of a community mental health4140
agency satisfy the certification standards established by rules4141
adopted under that section;4142

       (4) In accordance with criteria established under division4143
(G) of section 5119.61 of the Revised Code, review and evaluate4144
the quality, effectiveness, and efficiency of services provided4145
through its community mental health plan and submit its findings4146
and recommendations to the department of mental health;4147

       (5) In accordance with section 5119.22 of the Revised Code,4148
review applications for residential facility licenses and4149
recommend to the department of mental health approval or4150
disapproval of applications;4151

       (6) Audit, in accordance with rules adopted by the auditor of 4152
state pursuant to section 117.20 of the Revised Code, at least4153
annually all programs and services provided under contract with4154
the board. In so doing, the board may contract for or employ the4155
services of private auditors. A copy of the fiscal audit report4156
shall be provided to the director of mental health, the auditor of4157
state, and the county auditor of each county in the board's4158
district.4159

       (7) Recruit and promote local financial support for mental4160
health programs from private and public sources;4161

       (8)(a) Enter into contracts with public and private4162
facilities for the operation of facility services included in the4163
board's community mental health plan and enter into contracts with4164
public and private community mental health agencies for the4165
provision of community mental health services that are listed in 4166
section 340.09 of the Revised Code and included in the board's 4167
community mental health plan. The board may not contract with a 4168
community mental health agency to provide community mental health 4169
services included in the board's community mental health plan 4170
unless the services are certified by the director of mental health 4171
under section 5119.611 of the Revised Code. Section 307.86 of the 4172
Revised Code does not apply to contracts entered into under this 4173
division. In contracting with a community mental health agency, a 4174
board shall consider the cost effectiveness of services provided 4175
by that agency and the quality and continuity of care, and may 4176
review cost elements, including salary costs, of the services to 4177
be provided. A utilization review process shall be established as 4178
part of the contract for services entered into between a board and 4179
a community mental health agency. The board may establish this 4180
process in a way that is most effective and efficient in meeting 4181
local needs. In the case of a contract with a community mental 4182
health facility, as defined in section 5111.0235163.20 of the 4183
Revised Code, to provide services listed in division (B) of that 4184
section, the contract shall provide for the facility to be paid 4185
in accordance with the contract entered into between the4186
departments of job and family serviceshealth care administration4187
and mental health under section 5111.915161.05 of the Revised 4188
Code and any rules adopted under division (A) of section 5119.61 4189
of the Revised Code.4190

       If either the board or a facility or community mental health4191
agency with which the board contracts under division (A)(8)(a) of 4192
this section proposes not to renew the contract or proposes4193
substantial changes in contract terms, the other party shall be4194
given written notice at least one hundred twenty days before the4195
expiration date of the contract. During the first sixty days of4196
this one hundred twenty-day period, both parties shall attempt to4197
resolve any dispute through good faith collaboration and4198
negotiation in order to continue to provide services to persons in4199
need. If the dispute has not been resolved sixty days before the4200
expiration date of the contract, either party may notify the4201
department of mental health of the unresolved dispute. The4202
director may require both parties to submit the dispute to a third4203
party with the cost to be shared by the board and the facility or4204
community mental health agency. The third party shall issue to the 4205
board, the facility or agency, and the department recommendations 4206
on how the dispute may be resolved twenty days prior to the 4207
expiration date of the contract, unless both parties agree to a 4208
time extension. The director shall adopt rules establishing the 4209
procedures of this dispute resolution process.4210

       (b) With the prior approval of the director of mental health, 4211
a board may operate a facility or provide a community mental 4212
health service as follows, if there is no other qualified private 4213
or public facility or community mental health agency that is4214
immediately available and willing to operate such a facility or4215
provide the service:4216

       (i) In an emergency situation, any board may operate a4217
facility or provide a community mental health service in order to4218
provide essential services for the duration of the emergency;4219

       (ii) In a service district with a population of at least one4220
hundred thousand but less than five hundred thousand, a board may4221
operate a facility or provide a community mental health service4222
for no longer than one year;4223

       (iii) In a service district with a population of less than4224
one hundred thousand, a board may operate a facility or provide a4225
community mental health service for no longer than one year,4226
except that such a board may operate a facility or provide a4227
community mental health service for more than one year with the4228
prior approval of the director and the prior approval of the board4229
of county commissioners, or of a majority of the boards of county4230
commissioners if the district is a joint-county district.4231

       The director shall not give a board approval to operate a4232
facility or provide a community mental health service under4233
division (A)(8)(b)(ii) or (iii) of this section unless the4234
director determines that it is not feasible to have the department4235
operate the facility or provide the service.4236

       The director shall not give a board approval to operate a4237
facility or provide a community mental health service under4238
division (A)(8)(b)(iii) of this section unless the director4239
determines that the board will provide greater administrative4240
efficiency and more or better services than would be available if4241
the board contracted with a private or public facility or4242
community mental health agency.4243

       The director shall not give a board approval to operate a4244
facility previously operated by a person or other government4245
entity unless the board has established to the director's4246
satisfaction that the person or other government entity cannot4247
effectively operate the facility or that the person or other4248
government entity has requested the board to take over operation4249
of the facility. The director shall not give a board approval to4250
provide a community mental health service previously provided by a4251
community mental health agency unless the board has established to4252
the director's satisfaction that the agency cannot effectively4253
provide the service or that the agency has requested the board4254
take over providing the service.4255

       The director shall review and evaluate a board's operation of 4256
a facility and provision of community mental health service under4257
division (A)(8)(b) of this section.4258

       Nothing in division (A)(8)(b) of this section authorizes a4259
board to administer or direct the daily operation of any facility4260
or community mental health agency, but a facility or agency may4261
contract with a board to receive administrative services or staff4262
direction from the board under the direction of the governing body4263
of the facility or agency.4264

       (9) Approve fee schedules and related charges or adopt a unit 4265
cost schedule or other methods of payment for contract services 4266
provided by community mental health agencies in accordance with 4267
guidelines issued by the department as necessary to comply with 4268
state and federal laws pertaining to financial assistance;4269

       (10) Submit to the director and the county commissioners of4270
the county or counties served by the board, and make available to4271
the public, an annual report of the programs under the4272
jurisdiction of the board, including a fiscal accounting;4273

       (11) Establish, to the extent resources are available, a4274
community support system, which provides for treatment, support,4275
and rehabilitation services and opportunities. The essential4276
elements of the system include, but are not limited to, the4277
following components in accordance with section 5119.06 of the4278
Revised Code:4279

       (a) To locate persons in need of mental health services to4280
inform them of available services and benefits mechanisms;4281

       (b) Assistance for clients to obtain services necessary to4282
meet basic human needs for food, clothing, shelter, medical care,4283
personal safety, and income;4284

       (c) Mental health care, including, but not limited to,4285
outpatient, partial hospitalization, and, where appropriate,4286
inpatient care;4287

       (d) Emergency services and crisis intervention;4288

       (e) Assistance for clients to obtain vocational services and4289
opportunities for jobs;4290

       (f) The provision of services designed to develop social,4291
community, and personal living skills;4292

       (g) Access to a wide range of housing and the provision of4293
residential treatment and support;4294

       (h) Support, assistance, consultation, and education for4295
families, friends, consumers of mental health services, and4296
others;4297

       (i) Recognition and encouragement of families, friends,4298
neighborhood networks, especially networks that include racial and4299
ethnic minorities, churches, community organizations, and4300
meaningful employment as natural supports for consumers of mental4301
health services;4302

       (j) Grievance procedures and protection of the rights of4303
consumers of mental health services;4304

       (k) Case management, which includes continual individualized4305
assistance and advocacy to ensure that needed services are offered4306
and procured.4307

       (12) Designate the treatment program, agency, or facility for 4308
each person involuntarily committed to the board pursuant to4309
Chapter 5122. of the Revised Code and authorize payment for such4310
treatment. The board shall provide the least restrictive and most4311
appropriate alternative that is available for any person4312
involuntarily committed to it and shall assure that the services4313
listed in section 340.09 of the Revised Code are available to4314
severely mentally disabled persons residing within its service4315
district. The board shall establish the procedure for authorizing4316
payment for services, which may include prior authorization in4317
appropriate circumstances. The board may provide for services4318
directly to a severely mentally disabled person when life or4319
safety is endangered and when no community mental health agency is4320
available to provide the service.4321

       (13) Establish a method for evaluating referrals for4322
involuntary commitment and affidavits filed pursuant to section4323
5122.11 of the Revised Code in order to assist the probate4324
division of the court of common pleas in determining whether there4325
is probable cause that a respondent is subject to involuntary4326
hospitalization and what alternative treatment is available and4327
appropriate, if any;4328

       (14) Ensure that apartments or rooms built, subsidized,4329
renovated, rented, owned, or leased by the board or a community4330
mental health agency have been approved as meeting minimum fire4331
safety standards and that persons residing in the rooms or4332
apartments are receiving appropriate and necessary services,4333
including culturally relevant services, from a community mental4334
health agency. This division does not apply to residential4335
facilities licensed pursuant to section 5119.22 of the Revised4336
Code.4337

       (15) Establish a mechanism for involvement of consumer4338
recommendation and advice on matters pertaining to mental health4339
services in the alcohol, drug addiction, and mental health service4340
district;4341

       (16) Perform the duties under section 3722.18 of the Revised4342
Code required by rules adopted under section 5119.61 of the4343
Revised Code regarding referrals by the board or mental health4344
agencies under contract with the board of individuals with mental4345
illness or severe mental disability to adult care facilities and4346
effective arrangements for ongoing mental health services for the4347
individuals. The board is accountable in the manner specified in4348
the rules for ensuring that the ongoing mental health services are4349
effectively arranged for the individuals.4350

       (B) The board shall establish such rules, operating4351
procedures, standards, and bylaws, and perform such other duties4352
as may be necessary or proper to carry out the purposes of this4353
chapter.4354

       (C) A board of alcohol, drug addiction, and mental health4355
services may receive by gift, grant, devise, or bequest any4356
moneys, lands, or property for the benefit of the purposes for4357
which the board is established, and may hold and apply it4358
according to the terms of the gift, grant, or bequest. All money4359
received, including accrued interest, by gift, grant, or bequest4360
shall be deposited in the treasury of the county, the treasurer of4361
which is custodian of the alcohol, drug addiction, and mental4362
health services funds to the credit of the board and shall be4363
available for use by the board for purposes stated by the donor or4364
grantor.4365

       (D) No board member or employee of a board of alcohol, drug4366
addiction, and mental health services shall be liable for injury4367
or damages caused by any action or inaction taken within the scope4368
of the board member's official duties or the employee's4369
employment, whether or not such action or inaction is expressly4370
authorized by this section, section 340.033, or any other section4371
of the Revised Code, unless such action or inaction constitutes4372
willful or wanton misconduct. Chapter 2744. of the Revised Code4373
applies to any action or inaction by a board member or employee of4374
a board taken within the scope of the board member's official4375
duties or employee's employment. For the purposes of this4376
division, the conduct of a board member or employee shall not be4377
considered willful or wanton misconduct if the board member or4378
employee acted in good faith and in a manner that the board member4379
or employee reasonably believed was in or was not opposed to the4380
best interests of the board and, with respect to any criminal4381
action or proceeding, had no reasonable cause to believe the4382
conduct was unlawful.4383

       (E) The meetings held by any committee established by a board 4384
of alcohol, drug addiction, and mental health services shall be 4385
considered to be meetings of a public body subject to section4386
121.22 of the Revised Code.4387

       Sec. 340.091.  Each board of alcohol, drug addiction, and4388
mental health services shall contract with a community mental4389
health agency under division (A)(8)(a) of section 340.03 of the4390
Revised Code for the agency to do all of the following in4391
accordance with rules adopted under section 5119.61 of the Revised4392
Code for an individual referred to the agency under division4393
(C)(2) of section 173.355160.80 of the Revised Code:4394

       (A) Assess the individual to determine whether to recommend4395
that a PASSPORT administrative agency determine that the4396
environment in which the individual will be living while receiving4397
residential state supplement payments is appropriate for the4398
individual's needs and, if it determines the environment is4399
appropriate, issue the recommendation to the PASSPORT4400
administrative agency;4401

       (B) Provide ongoing monitoring to ensure that services4402
provided under section 340.09 of the Revised Code are available to4403
the individual;4404

       (C) Provide discharge planning to ensure the individual's4405
earliest possible transition to a less restrictive environment.4406

       Sec. 340.16. Not later than ninety days after September 5, 4407
2001, the department of mental health and the department of job 4408
and family services shall adopt rules that establish requirements 4409
and procedures for prior notification and service coordination 4410
between public children services agencies and boards of alcohol, 4411
drug addiction, and mental health services when a public children 4412
services agency refers a child in its custody to a board for 4413
services funded by the board. The rules shall be adopted in 4414
accordance with Chapter 119. of the Revised Code.4415

       The department of mental health and department of job and4416
family serviceshealth care administration shall collaborate in 4417
formulating a plan that delineates the funding responsibilities of 4418
public children services agencies and boards of alcohol, drug 4419
addiction, and mental health services for services provided under 4420
section 5111.0235163.20 of the Revised Code to children in the 4421
custody of public children services agencies. The departments 4422
shall complete the plan not later than ninety days after September 4423
5, 2001.4424

       Sec. 341.192. (A) As used in this section:4425

        (1) "Medical assistance program" has the same meaning as in 4426
section 2913.40 of the Revised Code.4427

       (2) "Medical provider" means a physician, hospital, 4428
laboratory, pharmacy, or other health care provider that is not 4429
employed by or under contract to a county, the department of youth 4430
services, or the department of rehabilitation and correction to 4431
provide medical services to persons confined in the county jail or 4432
a state correctional institution.4433

       (3)(2) "Necessary care" means medical care of a nonelective 4434
nature that cannot be postponed until after the period of 4435
confinement of a person who is confined in a county jail or a 4436
state correctional institution or is in the custody of a law 4437
enforcement officer without endangering the life or health of the 4438
person.4439

        (B) If a physician employed by or under contract to a county, 4440
the department of youth services, or the department of 4441
rehabilitation and correction to provide medical services to 4442
persons confined in the county jail or state correctional 4443
institution determines that a person who is confined in the county 4444
jail or a state correctional institution or who is in the custody 4445
of a law enforcement officer prior to the person's confinement in 4446
the county jail or a state correctional institution requires 4447
necessary care that the physician cannot provide, the necessary 4448
care shall be provided by a medical provider. The county, the 4449
department of youth services, or the department of rehabilitation 4450
and correction shall pay a medical provider for necessary care an 4451
amount not exceeding the authorized reimbursement rate for the 4452
same service established by the department of job and family 4453
serviceshealth care administration under the medical assistance4454
medicaid program.4455

       Sec. 505.84.  As used in this section, "authorized medicare 4456
reimbursement rate" means such rate established for the locality 4457
under Title XVIII of the "Social Security Act," 49 Stat. 620 4458
(1935), 42 U.S.C.A. 301, as amendedmedicare program.4459

       A board of township trustees may establish reasonable charges 4460
for the use of fire and rescue services, ambulance services, or 4461
emergency medical services. The board may establish different 4462
charges for township residents and nonresidents, and may, in its 4463
discretion, waive all or part of the charge for any resident. The 4464
charge for ambulance transportation for nonresidents shall be an 4465
amount not less than the authorized medicare reimbursement rate, 4466
except that, if prior to September 9, 1988, the board had 4467
different charges for residents and nonresidents and the charge 4468
for nonresidents was less than the authorized medicare 4469
reimbursement rate, the board may charge nonresidents less than 4470
the authorized medicare reimbursement rate.4471

       Charges collected under this section shall be kept in a4472
separate fund designated as "the fire and rescue services, 4473
ambulance services, and emergency medical services fund," and 4474
shall be appropriated and administered by the board. The fund 4475
shall be used for the payment of the costs of the management, 4476
maintenance, and operation of fire and rescue services, ambulance 4477
services, and emergency medical services in the township. If the 4478
fire and rescue services, ambulance services, and emergency 4479
medical services are discontinued in the township, any balance 4480
remaining in the fund shall be paid into the general fund of the 4481
township.4482

       Sec. 742.41.  (A) As used in this section:4483

       (1) "Other system retirant" has the same meaning as in4484
section 742.26 of the Revised Code.4485

       (2) "Personal history record" includes a member's, former4486
member's, or other system retirant's name, address, telephone4487
number, social security number, record of contributions,4488
correspondence with the Ohio police and fire pension fund, status4489
of any application for benefits, and any other information deemed4490
confidential by the trustees of the fund.4491

       (B) The treasurer of state shall furnish annually to the4492
board of trustees of the fund a sworn statement of the amount of4493
the funds in the treasurer of state's custody belonging to the4494
Ohio police and fire pension fund. The records of the fund shall4495
be open for public inspection except for the following, which4496
shall be excluded, except with the written authorization of the4497
individual concerned:4498

       (1) The individual's personal history record;4499

       (2) Any information identifying, by name and address, the4500
amount of a monthly allowance or benefit paid to the individual.4501

       (C) All medical reports and recommendations required are4502
privileged, except that copies of such medical reports or4503
recommendations shall be made available to the personal physician,4504
attorney, or authorized agent of the individual concerned upon4505
written release received from the individual or the individual's4506
agent or, when necessary for the proper administration of the4507
fund, to the board-assigned physician.4508

       (D) Any person who is a member of the fund or an other system 4509
retirant shall be furnished with a statement of the amount to the 4510
credit of the person's individual account upon the person's4511
written request. The fund need not answer more than one such4512
request of a person in any one year.4513

       (E) Notwithstanding the exceptions to public inspection in4514
division (B) of this section, the fund may furnish the following4515
information:4516

       (1) If a member, former member, or other system retirant is4517
subject to an order issued under section 2907.15 of the Revised4518
Code or an order issued under division (A) or (B) of section 4519
2929.192 of the Revised Code or is convicted of or pleads guilty 4520
to a violation of section 2921.41 of the Revised Code, on written 4521
request of a prosecutor as defined in section 2935.01 of the 4522
Revised Code, the fund shall furnish to the prosecutor the 4523
information requested from the individual's personal history 4524
record.4525

       (2) Pursuant to a court order issued pursuant to Chapter4526
3119., 3121., 3123., or 3125. of the Revised Code, the fund shall4527
furnish to a court or child support enforcement agency the4528
information required under that section.4529

       (3) At the request of any organization or association of4530
members of the fund, the fund shall provide a list of the names4531
and addresses of members of the fund and other system retirants.4532
The fund shall comply with the request of such organization or4533
association at least once a year and may impose a reasonable4534
charge for the list.4535

       (4) Within fourteen days after receiving from the director of 4536
job and family services a list of the names and social security4537
numbers of recipients of public assistance pursuant to section4538
5101.181 of the Revised Code or a list of the names and social 4539
security numbers of public medical assistance program recipients 4540
pursuant to section 5160.43 of the Revised Code, the fund shall 4541
inform the auditor of state of the name, current or most recent 4542
employer address, and social security number of each member or 4543
other system retirant whose name and social security number are 4544
the same as that of a person whose name or social security number 4545
was submitted by the directoris included on the list. The fund 4546
and its employees shall, except for purposes of furnishing the 4547
auditor of state with information required by this section, 4548
preserve the confidentiality of recipients of public assistance in 4549
compliance with division (A) of section 5101.181 of the Revised 4550
Code and preserve the confidentiality of public medical assistance 4551
program recipients in compliance with section 5160.43 of the 4552
Revised Code.4553

       (5) The fund shall comply with orders issued under section4554
3105.87 of the Revised Code.4555

       On the written request of an alternate payee, as defined in4556
section 3105.80 of the Revised Code, the fund shall furnish to the4557
alternate payee information on the amount and status of any4558
amounts payable to the alternate payee under an order issued under4559
section 3105.171 or 3105.65 of the Revised Code.4560

       (6) At the request of any person, the fund shall make 4561
available to the person copies of all documents, including 4562
resumes, in the fund's possession regarding filling a vacancy of a 4563
police officer employee member, firefighter employee member, 4564
police retirant member, or firefighter retirant member of the 4565
board of trustees. The person who made the request shall pay the 4566
cost of compiling, copying, and mailing the documents. The 4567
information described in this division is a public record.4568

       (F) A statement that contains information obtained from the4569
fund's records that is signed by the secretary of the board of4570
trustees of the Ohio police and fire pension fund and to which the4571
board's official seal is affixed, or copies of the fund's records4572
to which the signature and seal are attached, shall be received as4573
true copies of the fund's records in any court or before any4574
officer of this state.4575

       Sec. 955.201. (A) As used in this section and in section 4576
955.202 of the Revised Code, "Ohio pet fund" means a nonprofit 4577
corporation organized by that name under Chapter 1702. of the 4578
Revised Code that consists of humane societies, veterinarians, 4579
animal shelters, companion animal breeders, dog wardens, and 4580
similar individuals and entities.4581

        (B) The Ohio pet fund shall do all of the following:4582

       (1) Establish eligibility criteria for organizations that may4583
receive financial assistance from the pets program funding board 4584
created in section 955.202 of the Revised Code. Those 4585
organizations may include any of the following:4586

        (a) An animal shelter as defined in section 4729.01 of the4587
Revised Code;4588

       (b) A local nonprofit veterinary association that operates a4589
program for the sterilization of dogs and cats;4590

       (c) A charitable organization that is exempt from federal4591
income taxation under subsection 501(c)(3) of the Internal Revenue 4592
Code and the primary purpose of which is to support programs for 4593
the sterilization of dogs and cats and educational programs 4594
concerning the proper veterinary care of those animals.4595

       (2) Establish procedures for applying for financial 4596
assistance from the pets program funding board. Application 4597
procedures shall require eligible organizations to submit detailed 4598
proposals that outline the intended uses of the moneys sought.4599

       (3) Establish eligibility criteria for sterilization and4600
educational programs for which moneys from the pets program 4601
funding board may be used and, consistent with division (C) of 4602
this section, establish eligibility criteria for individuals who 4603
seek sterilization for their dogs and cats from eligible4604
organizations;4605

       (4) Establish procedures for the disbursement of moneys the 4606
pets program funding board receives from license plate 4607
contributions pursuant to division (C) of section 4503.551 of the 4608
Revised Code;4609

       (5) Advertise or otherwise provide notification of the4610
availability of financial assistance from the pets program funding 4611
board for eligible organizations;4612

       (6) Design markings to be inscribed on "pets" license plates 4613
under section 4503.551 of the Revised Code.4614

       (C)(1) The owner of a dog or cat is eligible for dog or cat4615
sterilization services from an eligible organization when those 4616
services are subsidized in whole or in part by money from the pets 4617
program funding board if any of the following applies:4618

       (a) The income of the owner's family does not exceed one 4619
hundred fifty per cent of the federal poverty guideline.4620

       (b) The owner, or any member of the owner's family who 4621
resides with the owner, is a recipient or beneficiary of one of 4622
the following government assistance programs:4623

       (i) Low-income housing assistance under the "United States 4624
Housing Act of 1937," 42 U.S.C.A. 1437f, as amended, known as the 4625
federal section 8 housing program;4626

       (ii) The Ohio works first program established by Chapter 4627
5107. of the Revised Code;4628

       (iii) Title XIX of the "Social Security Act," 49 Stat. 620 4629
(1935), 42 U.S.C.A. 301, as amended, known as the medical 4630
assistance program orThe medicaid, provided by the department of 4631
job and family services under Chapter 5111. of the Revised Code4632
program;4633

       (iv) A program or law administered by the United States 4634
department of veterans' affairs or veterans' administration for 4635
any service-connected disability;4636

       (v) The food stamp program established under the "Food Stamp 4637
Act of 1977," 91 Stat. 958, 7 U.S.C.A. 2011, as amended, 4638
administered by the department of job and family services under 4639
section 5101.54 of the Revised Code;4640

       (vi) The "special supplemental nutrition program for women, 4641
infants, and children" established under the "Child Nutrition Act 4642
of 1966," 80 Stat. 885, 42 U.S.C. 1786, as amended, administered 4643
by the department of health under section 3701.132 of the Revised 4644
Code;4645

       (vii) Supplemental security income under Title XVI of the 4646
"Social Security Act," 86 Stat. 1475 (1972), 42 U.S.C.A. 1383, as 4647
amended;4648

       (viii) Social security disability insurance benefits provided 4649
under Title II of the "Social Security Act," 49 Stat. 620 (1935), 4650
42 U.S.C.A. 401, as amended.4651

       (c) The owner of the dog or cat submits to the eligible4652
organization operating the sterilization program either of the4653
following:4654

       (i) A certificate of adoption showing that the dog or cat was4655
adopted from a licensed animal shelter, a municipal, county, or 4656
regional pound, or a holding and impoundment facility that 4657
contracts with a municipal corporation;4658

       (ii) A certificate of adoption showing that the dog or cat 4659
was adopted through a nonprofit corporation operating an animal 4660
adoption referral service whose holding facility, if any, is 4661
licensed in accordance with state law or a municipal ordinance.4662

       (2) The Ohio pet fund shall determine the type of documentary4663
evidence that must be presented by the owner of a dog or cat to4664
show that the income of the owner's family does not exceed one4665
hundred fifty per cent of the federal poverty guideline or that 4666
the owner is eligible under division (C)(1)(b) of this section.4667

       (D) As used in division (C) of this section, "federal poverty 4668
guideline" means the official poverty guideline as revised 4669
annually by the United States department of health and human 4670
services in accordance with section 673(2) of the "Omnibus Budget4671
Reconciliation Act of 1981," 95 Stat. 511, 42 U.S.C.A. 9902, as4672
amended, for a family size equal to the size of the family of the 4673
person whose income is being determined.4674

       Sec. 1337.11.  As used in sections 1337.11 to 1337.17 of the4675
Revised Code:4676

       (A) "Adult" means a person who is eighteen years of age or4677
older.4678

       (B) "Attending physician" means the physician to whom a4679
principal or the family of a principal has assigned primary4680
responsibility for the treatment or care of the principal or, if4681
the responsibility has not been assigned, the physician who has4682
accepted that responsibility.4683

       (C) "Comfort care" means any of the following:4684

       (1) Nutrition when administered to diminish the pain or4685
discomfort of a principal, but not to postpone death;4686

       (2) Hydration when administered to diminish the pain or4687
discomfort of a principal, but not to postpone death;4688

       (3) Any other medical or nursing procedure, treatment,4689
intervention, or other measure that is taken to diminish the pain4690
or discomfort of a principal, but not to postpone death.4691

       (D) "Consulting physician" means a physician who, in4692
conjunction with the attending physician of a principal, makes one4693
or more determinations that are required to be made by the4694
attending physician, or to be made by the attending physician and4695
one other physician, by an applicable provision of sections4696
1337.11 to 1337.17 of the Revised Code, to a reasonable degree of4697
medical certainty and in accordance with reasonable medical4698
standards.4699

       (E) "Declaration for mental health treatment" has the same4700
meaning as in section 2135.01 of the Revised Code.4701

       (F) "Guardian" means a person appointed by a probate court4702
pursuant to Chapter 2111. of the Revised Code to have the care and4703
management of the person of an incompetent.4704

       (G) "Health care" means any care, treatment, service, or4705
procedure to maintain, diagnose, or treat an individual's physical4706
or mental condition or physical or mental health.4707

       (H) "Health care decision" means informed consent, refusal to 4708
give informed consent, or withdrawal of informed consent to health 4709
care.4710

       (I) "Health care facility" means any of the following:4711

       (1) A hospital;4712

       (2) A hospice care program or other institution that4713
specializes in comfort care of patients in a terminal condition or4714
in a permanently unconscious state;4715

       (3) A nursing home;4716

       (4) A home health agency;4717

       (5) An intermediate care facility for the mentally retarded;4718

       (6) A regulated community mental health organization.4719

       (J) "Health care personnel" means physicians, nurses,4720
physician assistants, emergency medical technicians-basic,4721
emergency medical technicians-intermediate, emergency medical4722
technicians-paramedic, medical technicians, dietitians, other4723
authorized persons acting under the direction of an attending4724
physician, and administrators of health care facilities.4725

       (K) "Home health agency" has the same meaning as in section 4726
3701.881 of the Revised Code.4727

       (L) "Hospice care program" has the same meaning as in section 4728
3712.01 of the Revised Code.4729

       (M) "Hospital" has the same meanings as in sections 3701.01, 4730
3727.01, and 5122.01 of the Revised Code.4731

       (N) "Hydration" means fluids that are artificially or4732
technologically administered.4733

       (O) "Incompetent" has the same meaning as in section 2111.014734
of the Revised Code.4735

       (P) "Intermediate care facility for the mentally retarded"4736
has the same meaning as in section 5111.205164.01 of the Revised 4737
Code.4738

       (Q) "Life-sustaining treatment" means any medical procedure,4739
treatment, intervention, or other measure that, when administered4740
to a principal, will serve principally to prolong the process of4741
dying.4742

       (R) "Medical claim" has the same meaning as in section 4743
2305.113 of the Revised Code.4744

       (S) "Mental health treatment" has the same meaning as in4745
section 2135.01 of the Revised Code.4746

       (T) "Nursing home" has the same meaning as in section 3721.01 4747
of the Revised Code.4748

       (U) "Nutrition" means sustenance that is artificially or4749
technologically administered.4750

       (V) "Permanently unconscious state" means a state of4751
permanent unconsciousness in a principal that, to a reasonable4752
degree of medical certainty as determined in accordance with4753
reasonable medical standards by the principal's attending4754
physician and one other physician who has examined the principal,4755
is characterized by both of the following:4756

       (1) Irreversible unawareness of one's being and environment.4757

       (2) Total loss of cerebral cortical functioning, resulting in 4758
the principal having no capacity to experience pain or suffering.4759

       (W) "Person" has the same meaning as in section 1.59 of the4760
Revised Code and additionally includes political subdivisions and4761
governmental agencies, boards, commissions, departments,4762
institutions, offices, and other instrumentalities.4763

       (X) "Physician" means a person who is authorized under4764
Chapter 4731. of the Revised Code to practice medicine and surgery4765
or osteopathic medicine and surgery.4766

       (Y) "Political subdivision" and "state" have the same4767
meanings as in section 2744.01 of the Revised Code.4768

       (Z) "Professional disciplinary action" means action taken by4769
the board or other entity that regulates the professional conduct4770
of health care personnel, including the state medical board and4771
the board of nursing.4772

       (AA) "Regulated community mental health organization" means a 4773
residential facility as defined and licensed under section 5119.22 4774
of the Revised Code or a community mental health agency as defined 4775
in section 5122.01 of the Revised Code.4776

        (BB) "Terminal condition" means an irreversible, incurable,4777
and untreatable condition caused by disease, illness, or injury4778
from which, to a reasonable degree of medical certainty as4779
determined in accordance with reasonable medical standards by a4780
principal's attending physician and one other physician who has4781
examined the principal, both of the following apply:4782

       (1) There can be no recovery.4783

       (2) Death is likely to occur within a relatively short time4784
if life-sustaining treatment is not administered.4785

       (CC) "Tort action" means a civil action for damages for4786
injury, death, or loss to person or property, other than a civil4787
action for damages for a breach of contract or another agreement4788
between persons.4789

       Sec. 1347.08.  (A) Every state or local agency that maintains 4790
a personal information system, upon the request and the proper 4791
identification of any person who is the subject of personal 4792
information in the system, shall:4793

       (1) Inform the person of the existence of any personal4794
information in the system of which the person is the subject;4795

       (2) Except as provided in divisions (C) and (E)(2) of this4796
section, permit the person, the person's legal guardian, or an 4797
attorney who presents a signed written authorization made by the 4798
person, to inspect all personal information in the system of which 4799
the person is the subject;4800

       (3) Inform the person about the types of uses made of the4801
personal information, including the identity of any users usually4802
granted access to the system.4803

       (B) Any person who wishes to exercise a right provided by4804
this section may be accompanied by another individual of the 4805
person's choice.4806

       (C)(1) A state or local agency, upon request, shall disclose 4807
medical, psychiatric, or psychological information to a person who 4808
is the subject of the information or to the person's legal 4809
guardian, unless a physician, psychiatrist, or psychologist4810
determines for the agency that the disclosure of the information4811
is likely to have an adverse effect on the person, in which case4812
the information shall be released to a physician, psychiatrist, or 4813
psychologist who is designated by the person or by the person's 4814
legal guardian.4815

       (2) Upon the signed written request of either a licensed4816
attorney at law or a licensed physician designated by the inmate,4817
together with the signed written request of an inmate of a 4818
correctional institution under the administration of the4819
department of rehabilitation and correction, the department shall4820
disclose medical information to the designated attorney or4821
physician as provided in division (C) of section 5120.21 of the4822
Revised Code.4823

       (D) If an individual who is authorized to inspect personal4824
information that is maintained in a personal information system4825
requests the state or local agency that maintains the system to4826
provide a copy of any personal information that the individual is 4827
authorized to inspect, the agency shall provide a copy of the 4828
personal information to the individual. Each state and local 4829
agency may establish reasonable fees for the service of copying, 4830
upon request, personal information that is maintained by the 4831
agency.4832

       (E)(1) This section regulates access to personal information 4833
that is maintained in a personal information system by persons who 4834
are the subject of the information, but does not limit the 4835
authority of any person, including a person who is the subject of 4836
personal information maintained in a personal information system, 4837
to inspect or have copied, pursuant to section 149.43 of the 4838
Revised Code, a public record as defined in that section.4839

       (2) This section does not provide a person who is the subject 4840
of personal information maintained in a personal information 4841
system, the person's legal guardian, or an attorney authorized by 4842
the person, with a right to inspect or have copied, or require an 4843
agency that maintains a personal information system to permit the 4844
inspection of or to copy, a confidential law enforcement4845
investigatory record or trial preparation record, as defined in4846
divisions (A)(2) and (4) of section 149.43 of the Revised Code.4847

       (F) This section does not apply to any of the following:4848

       (1) The contents of an adoption file maintained by the 4849
department of health under section 3705.12 of the Revised Code;4850

       (2) Information contained in the putative father registry 4851
established by section 3107.062 of the Revised Code, regardless of 4852
whether the information is held by the department of job and 4853
family services or, pursuant to section 3111.69 of the Revised 4854
Code, the office of child support in the department or a child 4855
support enforcement agency;4856

       (3) Papers, records, and books that pertain to an adoption4857
and that are subject to inspection in accordance with section4858
3107.17 of the Revised Code;4859

       (4) Records listed in division (A) of section 3107.42 of the 4860
Revised Code or specified in division (A) of section 3107.52 of 4861
the Revised Code;4862

       (5) Records that identify an individual described in division 4863
(A)(1) of section 3721.031 of the Revised Code, or that would tend 4864
to identify such an individual;4865

       (6) Files and records that have been expunged under division 4866
(D)(1) of section 3721.23 of the Revised Code;4867

       (7) Records that identify an individual described in division 4868
(A)(1) of section 3721.25 of the Revised Code, or that would tend 4869
to identify such an individual;4870

       (8) Records that identify an individual described in division 4871
(A)(1) of section 5111.615164.77 of the Revised Code, or that4872
would tend to identify such an individual;4873

       (9) Test materials, examinations, or evaluation tools used in 4874
an examination for licensure as a nursing home administrator that 4875
the board of examiners of nursing home administrators administers 4876
under section 4751.04 of the Revised Code or contracts under that 4877
section with a private or government entity to administer;4878

       (10) Information contained in a database established and 4879
maintained pursuant to section 5101.13 of the Revised Code.4880

       Sec. 1731.04.  (A) An agreement between an alliance and an4881
insurer referred to in division (B) of section 1731.01 of the4882
Revised Code shall contain at least the following:4883

       (1) A provision requiring the insurer to offer and sell to4884
small employers served or to be served by an alliance one or more4885
health benefit plan options for coverage of their eligible4886
employees and the eligible dependents and members of the families4887
of the eligible employees and, if applicable, such members'4888
eligible retirees and the eligible dependents and members of the4889
families of the retirees, subject to such conditions and4890
restrictions as may be set forth or incorporated into the4891
agreement;4892

       (2) A brief description of each type of health benefit plan 4893
option that is to be so offered and the conditions for the4894
modification, continuation, and termination of the coverage and4895
benefits thereunder;4896

       (3) A statement of the eligibility requirements that an4897
employee or retiree must meet in order for the employee or retiree 4898
to be eligible to obtain and retain coverage under any health 4899
benefit plan option so offered and, if one of such requirements is 4900
that an employee must regularly work for a minimum number of hours 4901
per week, a statement of such minimum number of hours, which 4902
minimum shall not exceed twenty-five hours per week;4903

       (4) A description of any pre-existing condition and waiting 4904
period rules;4905

       (5) A statement of the premium rates or other charges that4906
apply to each health benefit plan option or a formula or method of 4907
determining the rates or charges;4908

       (6) A provision prescribing the minimum employer contribution 4909
toward premiums or other charges required in order to permit a 4910
small employer to obtain coverage under a health benefit plan 4911
option offered under an alliance program;4912

       (7) A provision requiring that each health benefit plan under 4913
the alliance program must provide for the continuation of coverage 4914
of participants of an enrolled small employer so long as the small 4915
employer determines that such person is a qualified beneficiary 4916
entitled to such coverage pursuant to Part 6 of Title I of the 4917
"Federal Employee Retirement Income Security Act of 1974," 88 4918
Stat. 832, 29 U.S.C.A. 1001, and the laws of this state, and 4919
regulations or rulings interpreting such provisions. Such coverage 4920
provided by the insurer under the plan to participants shall 4921
comply with the "Federal Employee Retirement Income Security Act 4922
of 1974" and the relevant statutes, regulations, and rulings 4923
interpreting that act, including provisions regarding types of 4924
coverage to be provided, apportionments of limitations on 4925
coverage, apportionments of deductibles, and the rights of 4926
qualified beneficiaries to elect coverage options relating to 4927
types of coverage and otherwise.4928

       (B) An agreement between an alliance and an insurer referred 4929
to in division (B) of section 1731.01 of the Revised Code may 4930
contain provisions relating to, but not limited to, any of the 4931
following:4932

       (1) The application and enrollment process for a small4933
employer and related provisions pertaining to historical4934
experience, health statements, and underwriting standards;4935

       (2) The minimum number of those employees eligible to be4936
participants that are required to participate in order to permit a 4937
small employer to obtain coverage under a health benefit plan4938
option offered under the alliance program, which may vary with the 4939
number of employees or those eligible to be participants in4940
respect of the small employer;4941

       (3) A procedure for allowing an enrolled small employer to4942
change from one plan option to another under the alliance program, 4943
subject to qualifying by size or otherwise under the alliance 4944
program;4945

       (4) The application of any risk-related pooling or grouping 4946
programs and related premiums, conditions, reviews, and4947
alternatives offered by the insurer;4948

       (5) The availability of a medicare supplement coverage option 4949
for eligible participants who are covered by Parts A and B of the4950
medicare, Title XVIII of the "Social Security Act," 49 Stat. 620 4951
(1935), 42 U.S.C.A. 301program;4952

       (6) Relevant experience periods, enrollment periods, and4953
contract periods;4954

       (7) Effective dates for coverage of eligible participants;4955

       (8) Conditions under which denial or withdrawal of coverage 4956
of participants or small employers and their employees may occur 4957
by reason of falsification or misrepresentation of material facts 4958
or criminal conduct toward the insurer, small employer, or 4959
alliance under the program;4960

       (9) Premium rate structures, which may be uniform or make4961
provision for age-specific rates, differentials based on number of 4962
participants of an enrolled small employer, products and plan4963
options selected, and other factors, rate adjustments based on4964
consumer price indices, utilization, or other relevant factors,4965
notification of rate adjustments, and arbitration;4966

       (10) Any responsibilities of the alliance for billing,4967
collection, and transmittal of premiums;4968

       (11) Inclusion under the alliance program of small employers 4969
that are members of other organizations described in division 4970
(A)(1) of section 1731.01 of the Revised Code that contract with 4971
the alliance for this purpose, and conditions pertaining to those 4972
small employer members and to their employees and retirees, and 4973
dependents and family members of those employees or retirees, as 4974
applicable under the alliance program;4975

       (12) The agreement of the insurer to offer and sell one or4976
more health benefit plans to small employer members of another4977
small employer health care alliance that contracts with the4978
alliance for this purpose;4979

       (13) Use of the health benefit plan options of the insurer in 4980
the alliance program and use of the names of the alliance and the 4981
insurer;4982

       (14) Indemnification from claims and liability by reason of 4983
acts or omissions of others;4984

       (15) Ownership, use, availability, and maintenance of 4985
confidentiality of data and records relating to the alliance 4986
program;4987

       (16) Utilization reports to be provided to the alliance by4988
the insurer;4989

       (17) Such other provisions as may be agreed upon by the4990
alliance and the insurer to better provide for the articulation,4991
promotion, financing, and operation of the alliance program or a4992
health benefit plan under the program in furtherance of the public 4993
purposes stated in section 1731.02 of the Revised Code.4994

       (C) Neither an alliance program nor an agreement between an 4995
alliance and an insurer is itself a policy or contract of4996
insurance, or a certificate, indorsement, rider, or application4997
forming any part of a policy, contract, or certificate of4998
insurance. Chapters 3905., 3933., and 3959. of the Revised Code do 4999
not apply to an alliance program or to an agreement between an5000
alliance and an insurer thereunder, as such, or to the functions5001
of the alliance under an alliance program.5002

       Sec. 1739.061. (A)(1) This section applies to both of the 5003
following:5004

       (a) A multiple employer welfare arrangement that issues or 5005
requires the use of a standardized identification card or an 5006
electronic technology for submission and routing of prescription 5007
drug claims;5008

        (b) A person or entity that a multiple employer welfare 5009
arrangement contracts with to issue a standardized identification 5010
card or an electronic technology described in division (A)(1)(a) 5011
of this section.5012

       (2) Notwithstanding division (A)(1) of this section, this 5013
section does not apply to the issuance or required use of a5014
standardized identification card or an electronic technology for 5015
the submission and routing of prescription drug claims in 5016
connection with any of the following:5017

       (a) Any program or arrangement covering only accident, 5018
credit, dental, disability income, long-term care, hospital 5019
indemnity, medicare supplement, medicare, tricare, specified 5020
disease, or vision care; coverage under a 5021
one-time-limited-duration policy of not longer than six months; 5022
coverage issued as a supplement to liability insurance; insurance 5023
arising out of workers' compensation or similar law; automobile 5024
medical payment insurance; or insurance under which benefits are 5025
payable with or without regard to fault and which is statutorily 5026
required to be contained in any liability insurance policy or 5027
equivalent self-insurance.5028

       (b) Coverage provided under the medicaid, as defined in 5029
section 5111.01 of the Revised Codeprogram.5030

       (c) Coverage provided under an employer's self-insurance plan 5031
or by any of its administrators, as defined in section 3959.01 of 5032
the Revised Code, to the extent that federal law supersedes, 5033
preempts, prohibits, or otherwise precludes the application of 5034
this section to the plan and its administrators.5035

       (B) A standardized identification card or an electronic5036
technology issued or required to be used as provided in division 5037
(A)(1) of this section shall contain uniform prescription drug 5038
information in accordance with either division (B)(1) or (2) of 5039
this section.5040

        (1) The standardized identification card or the electronic 5041
technology shall be in a format and contain information fields 5042
approved by the national council for prescription drug programs or 5043
a successor organization, as specified in the council's or 5044
successor organization's pharmacy identification card 5045
implementation guide in effect on the first day of October most 5046
immediately preceding the issuance or required use of the 5047
standardized identification card or the electronic technology.5048

        (2) If the multiple employer welfare arrangement or person 5049
under contract with it to issue a standardized identification card 5050
or an electronic technology requires the information for the 5051
submission and routing of a claim, the standardized identification 5052
card or the electronic technology shall contain any of the5053
following information:5054

        (a) The name of the multiple employer welfare arrangement;5055

        (b) The individual's name, group number, and identification5056
number;5057

       (c) A telephone number to inquire about pharmacy-related 5058
issues;5059

        (d) The issuer's international identification number, labeled 5060
as "ANSI BIN" or "RxBIN";5061

        (e) The processor's control number, labeled as "RxPCN";5062

        (f) The individual's pharmacy benefits group number if5063
different from the insured's medical group number, labeled as5064
"RxGrp."5065

        (C) If the standardized identification card or the electronic 5066
technology issued or required to be used as provided in division 5067
(A)(1) of this section is also used for submission and routing of 5068
nonpharmacy claims, the designation "Rx" is required to be 5069
included as part of the labels identified in divisions (B)(2)(d) 5070
and (e) of this section if the issuer's international 5071
identification number or the processor's control number is 5072
different for medical and pharmacy claims.5073

        (D) Each multiple employer welfare arrangement described in 5074
division (A) of this section shall annually file a certificate 5075
with the superintendent of insurance certifying that it or any 5076
person it contracts with to issue a standardized identification 5077
card or electronic technology for submission and routing of 5078
prescription drug claims complies with this section.5079

       (E)(1) Except as provided in division (E)(2) of this section, 5080
if there is a change in the information contained in the 5081
standardized identification card or the electronic technology 5082
issued to an individual, the multiple employer welfare arrangement 5083
or person under contract with it to issue a standardized 5084
identification card or an electronic technology shall issue a new 5085
card or electronic technology to the individual.5086

        (2) A multiple employer welfare arrangement or person under 5087
contract with it is not required under division (E)(1) of this 5088
section to issue a new card or electronic technology to an5089
individual more than once during a twelve-month period.5090

        (F) Nothing in this section shall be construed as requiring a 5091
multiple employer welfare arrangement to produce more than one 5092
standardized identification card or one electronic technology for 5093
use by individuals accessing health care benefits provided under a 5094
multiple employer welfare arrangement.5095

       Sec. 1751.01.  As used in this chapter:5096

       (A)(1) "Basic health care services" means the following 5097
services when medically necessary:5098

       (a) Physician's services, except when such services are5099
supplemental under division (B) of this section;5100

       (b) Inpatient hospital services;5101

       (c) Outpatient medical services;5102

       (d) Emergency health services;5103

       (e) Urgent care services;5104

       (f) Diagnostic laboratory services and diagnostic and5105
therapeutic radiologic services;5106

       (g) Diagnostic and treatment services, other than 5107
prescription drug services, for biologically based mental 5108
illnesses;5109

       (h) Preventive health care services, including, but not5110
limited to, voluntary family planning services, infertility5111
services, periodic physical examinations, prenatal obstetrical5112
care, and well-child care;5113

       (i) Routine patient care for patients enrolled in an eligible 5114
cancer clinical trial pursuant to section 3923.80 of the Revised 5115
Code.5116

       "Basic health care services" does not include experimental5117
procedures.5118

        Except as provided by divisions (A)(2) and (3) of this 5119
section in connection with the offering of coverage for diagnostic 5120
and treatment services for biologically based mental illnesses, a 5121
health insuring corporation shall not offer coverage for a health 5122
care service, defined as a basic health care service by this 5123
division, unless it offers coverage for all listed basic health 5124
care services. However, this requirement does not apply to the 5125
coverage of beneficiaries enrolled in medicare pursuant to a 5126
medicare contract, or to the coverage of beneficiaries enrolled 5127
in the federal employee health benefits program pursuant to 55128
U.S.C.A. 8905, or to the coverage of medicaid recipients, or to 5129
the coverage of participants of the children's buy-in program, or 5130
to the coverage of beneficiaries under any federal health care5131
program regulated by a federal regulatory body, or to the 5132
coverage of beneficiaries under any contract covering officers or 5133
employees of the state that has been entered into by the 5134
department of administrative services.5135

       (2) A health insuring corporation may offer coverage for 5136
diagnostic and treatment services for biologically based mental 5137
illnesses without offering coverage for all other basic health 5138
care services. A health insuring corporation may offer coverage 5139
for diagnostic and treatment services for biologically based 5140
mental illnesses alone or in combination with one or more 5141
supplemental health care services. However, a health insuring 5142
corporation that offers coverage for any other basic health care 5143
service shall offer coverage for diagnostic and treatment services 5144
for biologically based mental illnesses in combination with the 5145
offer of coverage for all other listed basic health care services.5146

       (3) A health insuring corporation that offers coverage for 5147
basic health care services is not required to offer coverage for 5148
diagnostic and treatment services for biologically based mental 5149
illnesses in combination with the offer of coverage for all other 5150
listed basic health care services if all of the following apply:5151

       (a) The health insuring corporation submits documentation 5152
certified by an independent member of the American academy of 5153
actuaries to the superintendent of insurance showing that incurred 5154
claims for diagnostic and treatment services for biologically 5155
based mental illnesses for a period of at least six months 5156
independently caused the health insuring corporation's costs for 5157
claims and administrative expenses for the coverage of basic 5158
health care services to increase by more than one per cent per 5159
year. 5160

       (b) The health insuring corporation submits a signed letter 5161
from an independent member of the American academy of actuaries to 5162
the superintendent of insurance opining that the increase in costs 5163
described in division (A)(3)(a) of this section could reasonably 5164
justify an increase of more than one per cent in the annual 5165
premiums or rates charged by the health insuring corporation for 5166
the coverage of basic health care services.5167

       (c) The superintendent of insurance makes the following 5168
determinations from the documentation and opinion submitted 5169
pursuant to divisions (A)(3)(a) and (b) of this section:5170

       (i) Incurred claims for diagnostic and treatment services for 5171
biologically based mental illnesses for a period of at least six 5172
months independently caused the health insuring corporation's 5173
costs for claims and administrative expenses for the coverage of 5174
basic health care services to increase by more than one per cent 5175
per year.5176

       (ii) The increase in costs reasonably justifies an increase 5177
of more than one per cent in the annual premiums or rates charged 5178
by the health insuring corporation for the coverage of basic 5179
health care services. 5180

       Any determination made by the superintendent under this 5181
division is subject to Chapter 119. of the Revised Code.5182

       (B)(1) "Supplemental health care services" means any health 5183
care services other than basic health care services that a health 5184
insuring corporation may offer, alone or in combination with 5185
either basic health care services or other supplemental health 5186
care services, and includes:5187

       (a) Services of facilities for intermediate or long-term5188
care, or both;5189

       (b) Dental care services;5190

       (c) Vision care and optometric services including lenses and 5191
frames;5192

       (d) Podiatric care or foot care services;5193

       (e) Mental health services, excluding diagnostic and 5194
treatment services for biologically based mental illnesses;5195

       (f) Short-term outpatient evaluative and crisis-intervention 5196
mental health services;5197

       (g) Medical or psychological treatment and referral services 5198
for alcohol and drug abuse or addiction;5199

       (h) Home health services;5200

       (i) Prescription drug services;5201

       (j) Nursing services;5202

       (k) Services of a dietitian licensed under Chapter 4759. of 5203
the Revised Code;5204

       (l) Physical therapy services;5205

       (m) Chiropractic services;5206

       (n) Any other category of services approved by the5207
superintendent of insurance.5208

       (2) If a health insuring corporation offers prescription 5209
drug services under this division, the coverage shall include 5210
prescription drug services for the treatment of biologically based 5211
mental illnesses on the same terms and conditions as other 5212
physical diseases and disorders.5213

       (C) "Specialty health care services" means one of the5214
supplemental health care services listed in division (B) of this 5215
section, when provided by a health insuring corporation on an 5216
outpatient-only basis and not in combination with other 5217
supplemental health care services.5218

       (D) "Biologically based mental illnesses" means 5219
schizophrenia, schizoaffective disorder, major depressive 5220
disorder, bipolar disorder, paranoia and other psychotic 5221
disorders, obsessive-compulsive disorder, and panic disorder, as 5222
these terms are defined in the most recent edition of the 5223
diagnostic and statistical manual of mental disorders published by 5224
the American psychiatric association.5225

       (E) "Children's buy-in program" has the same meaning as in 5226
section 5101.5211 of the Revised Code.5227

       (F) "Closed panel plan" means a health care plan that5228
requires enrollees to use participating providers.5229

       (G)(F) "Compensation" means remuneration for the provision of 5230
health care services, determined on other than a fee-for-service 5231
or discounted-fee-for-service basis.5232

       (H)(G) "Contractual periodic prepayment" means the formula 5233
for determining the premium rate for all subscribers of a health 5234
insuring corporation.5235

       (I)(H) "Corporation" means a corporation formed under Chapter 5236
1701. or 1702. of the Revised Code or the similar laws of another 5237
state.5238

       (J)(I) "Emergency health services" means those health care 5239
services that must be available on a seven-days-per-week, 5240
twenty-four-hours-per-day basis in order to prevent jeopardy to an 5241
enrollee's health status that would occur if such services were 5242
not received as soon as possible, and includes, where appropriate, 5243
provisions for transportation and indemnity payments or service 5244
agreements for out-of-area coverage.5245

       (K)(J) "Enrollee" means any natural person who is entitled to 5246
receive health care benefits provided by a health insuring 5247
corporation.5248

       (L)(K) "Evidence of coverage" means any certificate, 5249
agreement, policy, or contract issued to a subscriber that sets 5250
out the coverage and other rights to which such person is 5251
entitled under a health care plan.5252

       (M)(L) "Health care facility" means any facility, except a 5253
health care practitioner's office, that provides preventive, 5254
diagnostic, therapeutic, acute convalescent, rehabilitation, 5255
mental health, mental retardation, intermediate care, or skilled 5256
nursing services.5257

       (N)(M) "Health care services" means basic, supplemental, and 5258
specialty health care services.5259

       (O)(N) "Health delivery network" means any group of providers 5260
or health care facilities, or both, or any representative thereof, 5261
that have entered into an agreement to offer health care services 5262
in a panel rather than on an individual basis.5263

       (P)(O) "Health insuring corporation" means a corporation, as 5264
defined in division (I)(H) of this section, that, pursuant to a 5265
policy, contract, certificate, or agreement, pays for, reimburses, 5266
or provides, delivers, arranges for, or otherwise makes available, 5267
basic health care services, supplemental health care services, or5268
specialty health care services, or a combination of basic health5269
care services and either supplemental health care services or5270
specialty health care services, through either an open panel plan 5271
or a closed panel plan.5272

       "Health insuring corporation" does not include a limited 5273
liability company formed pursuant to Chapter 1705. of the Revised5274
Code, an insurer licensed under Title XXXIX of the Revised Code if 5275
that insurer offers only open panel plans under which all 5276
providers and health care facilities participating receive their 5277
compensation directly from the insurer, a corporation formed by or 5278
on behalf of a political subdivision or a department, office, or 5279
institution of the state, or a public entity formed by or on 5280
behalf of a board of county commissioners, a county board of 5281
mental retardation and developmental disabilities, an alcohol and 5282
drug addiction services board, a board of alcohol, drug addiction,5283
and mental health services, or a community mental health board, as 5284
those terms are used in Chapters 340. and 5126. of the Revised 5285
Code. Except as provided by division (D) of section 1751.02 of 5286
the Revised Code, or as otherwise provided by law, no board, 5287
commission, agency, or other entity under the control of a 5288
political subdivision may accept insurance risk in providing for 5289
health care services. However, nothing in this division shall be5290
construed as prohibiting such entities from purchasing the5291
services of a health insuring corporation or a third-party5292
administrator licensed under Chapter 3959. of the Revised Code.5293

       (Q)(P) "Intermediary organization" means a health delivery 5294
network or other entity that contracts with licensed health 5295
insuring corporations or self-insured employers, or both, to5296
provide health care services, and that enters into contractual 5297
arrangements with other entities for the provision of health care 5298
services for the purpose of fulfilling the terms of its contracts 5299
with the health insuring corporations and self-insured employers.5300

       (R)(Q) "Intermediate care" means residential care above the 5301
level of room and board for patients who require personal 5302
assistance and health-related services, but who do not require 5303
skilled nursing care.5304

       (S) "Medicaid" has the same meaning as in section 5111.01 of 5305
the Revised Code.5306

       (T)(R) "Medical record" means the personal information that 5307
relates to an individual's physical or mental condition, medical 5308
history, or medical treatment.5309

       (U) "Medicare" means the program established under Title 5310
XVIII of the "Social Security Act" 49 Stat. 620 (1935), 42 U.S.C. 5311
1395, as amended.5312

       (V)(S)(1) "Open panel plan" means a health care plan that 5313
provides incentives for enrollees to use participating providers 5314
and that also allows enrollees to use providers that are not 5315
participating providers.5316

       (2) No health insuring corporation may offer an open panel 5317
plan, unless the health insuring corporation is also licensed as 5318
an insurer under Title XXXIX of the Revised Code, the health 5319
insuring corporation, on June 4, 1997, holds a certificate of 5320
authority or license to operate under Chapter 1736. or 1740. of5321
the Revised Code, or an insurer licensed under Title XXXIX of the 5322
Revised Code is responsible for the out-of-network risk as 5323
evidenced by both an evidence of coverage filing under section 5324
1751.11 of the Revised Code and a policy and certificate filing 5325
under section 3923.02 of the Revised Code.5326

       (W)(T) "Panel" means a group of providers or health care5327
facilities that have joined together to deliver health care5328
services through a contractual arrangement with a health insuring 5329
corporation, employer group, or other payor.5330

       (X)(U) "Person" has the same meaning as in section 1.59 of 5331
the Revised Code, and, unless the context otherwise requires,5332
includes any insurance company holding a certificate of authority 5333
under Title XXXIX of the Revised Code, any subsidiary and 5334
affiliate of an insurance company, and any government agency.5335

       (Y)(V) "Premium rate" means any set fee regularly paid by a 5336
subscriber to a health insuring corporation. A "premium rate" does 5337
not include a one-time membership fee, an annual administrative 5338
fee, or a nominal access fee, paid to a managed health care system 5339
under which the recipient of health care services remains solely 5340
responsible for any charges accessed for those services by the 5341
provider or health care facility.5342

       (Z)(W) "Primary care provider" means a provider that is 5343
designated by a health insuring corporation to supervise, 5344
coordinate, or provide initial care or continuing care to an 5345
enrollee, and that may be required by the health insuring 5346
corporation to initiate a referral for specialty care and to 5347
maintain supervision of the health care services rendered to the 5348
enrollee.5349

       (AA)(X) "Provider" means any natural person or partnership of 5350
natural persons who are licensed, certified, accredited, or 5351
otherwise authorized in this state to furnish health care 5352
services, or any professional association organized under Chapter 5353
1785. of the Revised Code, provided that nothing in this chapter 5354
or other provisions of law shall be construed to preclude a health 5355
insuring corporation, health care practitioner, or organized 5356
health care group associated with a health insuring corporation 5357
from employing certified nurse practitioners, certified nurse 5358
anesthetists, clinical nurse specialists, certified nurse5359
midwives, dietitians, physician assistants, dental assistants, 5360
dental hygienists, optometric technicians, or other allied health5361
personnel who are licensed, certified, accredited, or otherwise5362
authorized in this state to furnish health care services.5363

       (BB)(Y) "Provider sponsored organization" means a 5364
corporation, as defined in division (I)(H) of this section, that 5365
is at least eighty per cent owned or controlled by one or more 5366
hospitals, as defined in section 3727.01 of the Revised Code, or 5367
one or more physicians licensed to practice medicine or surgery 5368
or osteopathic medicine and surgery under Chapter 4731. of the 5369
Revised Code, or any combination of such physicians and hospitals. 5370
Such control is presumed to exist if at least eighty per cent of 5371
the voting rights or governance rights of a provider sponsored 5372
organization are directly or indirectly owned, controlled, or 5373
otherwise held by any combination of the physicians and hospitals 5374
described in this division.5375

       (CC)(Z) "Solicitation document" means the written materials5376
provided to prospective subscribers or enrollees, or both, and 5377
used for advertising and marketing to induce enrollment in the 5378
health care plans of a health insuring corporation.5379

       (DD)(AA) "Subscriber" means a person who is responsible for 5380
making payments to a health insuring corporation for participation 5381
in a health care plan, or an enrollee whose employment or other 5382
status is the basis of eligibility for enrollment in a health 5383
insuring corporation.5384

       (EE)(BB) "Urgent care services" means those health care 5385
services that are appropriately provided for an unforeseen 5386
condition of a kind that usually requires medical attention 5387
without delay but that does not pose a threat to the life, limb, 5388
or permanent health of the injured or ill person, and may include 5389
such health care services provided out of the health insuring 5390
corporation's approved service area pursuant to indemnity 5391
payments or service agreements.5392

       Sec. 1751.11.  (A) Every subscriber of a health insuring5393
corporation is entitled to an evidence of coverage for the health5394
care plan under which health care benefits are provided.5395

       (B) Every subscriber of a health insuring corporation that 5396
offers basic health care services is entitled to an identification 5397
card or similar document that specifies the health insuring5398
corporation's name as stated in its articles of incorporation, and5399
any trade or fictitious names used by the health insuring5400
corporation. The identification card or document shall list at5401
least one toll-free telephone number that provides the subscriber5402
with access, to information on a twenty-four-hours-per-day,5403
seven-days-per-week basis, as to how health care services may be5404
obtained. The identification card or document shall also list at5405
least one toll-free number that, during normal business hours,5406
provides the subscriber with access to information on the coverage5407
available under the subscriber's health care plan and information5408
on the health care plan's internal and external review processes.5409

       (C) No evidence of coverage, or amendment to the evidence of5410
coverage, shall be delivered, issued for delivery, renewed, or5411
used, until the form of the evidence of coverage or amendment has5412
been filed by the health insuring corporation with the5413
superintendent of insurance. If the superintendent does not5414
disapprove the evidence of coverage or amendment within sixty days5415
after it is filed it shall be deemed approved, unless the5416
superintendent sooner gives approval for the evidence of coverage5417
or amendment. With respect to an amendment to an approved evidence 5418
of coverage, the superintendent only may disapprove provisions 5419
amended or added to the evidence of coverage. If the5420
superintendent determines within the sixty-day period that any5421
evidence of coverage or amendment fails to meet the requirements5422
of this section, the superintendent shall so notify the health5423
insuring corporation and it shall be unlawful for the health5424
insuring corporation to use such evidence of coverage or5425
amendment. At any time, the superintendent, upon at least thirty5426
days' written notice to a health insuring corporation, may5427
withdraw an approval, deemed or actual, of any evidence of5428
coverage or amendment on any of the grounds stated in this5429
section. Such disapproval shall be effected by a written order,5430
which shall state the grounds for disapproval and shall be issued5431
in accordance with Chapter 119. of the Revised Code.5432

       (D) No evidence of coverage or amendment shall be delivered,5433
issued for delivery, renewed, or used:5434

       (1) If it contains provisions or statements that are 5435
inequitable, untrue, misleading, or deceptive;5436

       (2) Unless it contains a clear, concise, and complete 5437
statement of the following:5438

       (a) The health care services and insurance or other benefits, 5439
if any, to which an enrollee is entitled under the health care 5440
plan;5441

       (b) Any exclusions or limitations on the health care 5442
services, type of health care services, benefits, or type of 5443
benefits to be provided, including copayments and deductibles;5444

       (c) An enrollee's personal financial obligation for 5445
noncovered services;5446

       (d) Where and in what manner general information and 5447
information as to how health care services may be obtained is 5448
available, including a toll-free telephone number;5449

       (e) The premium rate with respect to individual and 5450
conversion contracts, and relevant copayment and deductible 5451
provisions with respect to all contracts. The statement of the 5452
premium rate, however, may be contained in a separate insert.5453

       (f) The method utilized by the health insuring corporation 5454
for resolving enrollee complaints;5455

       (g) The utilization review, internal review, and external 5456
review procedures established under sections 1751.77 to 1751.85 of 5457
the Revised Code.5458

       (3) Unless it provides for the continuation of an enrollee's5459
coverage, in the event that the enrollee's coverage under the5460
group policy, contract, certificate, or agreement terminates while5461
the enrollee is receiving inpatient care in a hospital. This5462
continuation of coverage shall terminate at the earliest5463
occurrence of any of the following:5464

       (a) The enrollee's discharge from the hospital;5465

       (b) The determination by the enrollee's attending physician 5466
that inpatient care is no longer medically indicated for the 5467
enrollee; however, nothing in division (D)(3)(b) of this section 5468
precludes a health insuring corporation from engaging in 5469
utilization review as described in the evidence of coverage.5470

       (c) The enrollee's reaching the limit for contractual 5471
benefits;5472

       (d) The effective date of any new coverage.5473

       (4) Unless it contains a provision that states, in substance,5474
that the health insuring corporation is not a member of any5475
guaranty fund, and that in the event of the health insuring5476
corporation's insolvency, an enrollee is protected only to the5477
extent that the hold harmless provision required by section5478
1751.13 of the Revised Code applies to the health care services5479
rendered;5480

       (5) Unless it contains a provision that states, in substance,5481
that in the event of the insolvency of the health insuring5482
corporation, an enrollee may be financially responsible for health5483
care services rendered by a provider or health care facility that5484
is not under contract to the health insuring corporation, whether5485
or not the health insuring corporation authorized the use of the5486
provider or health care facility.5487

       (E) Notwithstanding divisions (C) and (D) of this section, a5488
health insuring corporation may use an evidence of coverage that5489
provides for the coverage of beneficiaries enrolled in medicare 5490
pursuant to a medicare contract, or an evidence of coverage that 5491
provides for the coverage of beneficiaries enrolled in the 5492
federal employees health benefits program pursuant to 5 U.S.C.A. 5493
8905, or an evidence of coverage that provides for the coverage 5494
of medicaid recipients, or an evidence of coverage that provides 5495
for coverage of participants of the children's buy-in program, or 5496
an evidence of coverage that provides for the coverage of 5497
beneficiaries under any other federal health care program 5498
regulated by a federal regulatory body, or an evidence of5499
coverage that provides for the coverage of beneficiaries under 5500
any contract covering officers or employees of the state that has 5501
been entered into by the department of administrative services, 5502
if both of the following apply:5503

       (1) The evidence of coverage has been approved by the United5504
States department of health and human services, the United States5505
office of personnel management, the Ohio department of job and5506
family serviceshealth care administration, or the department of 5507
administrative services.5508

       (2) The evidence of coverage is filed with the superintendent 5509
of insurance prior to use and is accompanied by documentation of5510
approval from the United States department of health and human5511
services, the United States office of personnel management, the5512
Ohio department of job and family serviceshealth care 5513
administration, or the department of administrative services.5514

       Sec. 1751.12.  (A)(1) No contractual periodic prepayment and 5515
no premium rate for nongroup and conversion policies for health 5516
care services, or any amendment to them, may be used by any health 5517
insuring corporation at any time until the contractual periodic 5518
prepayment and premium rate, or amendment, have been filed with 5519
the superintendent of insurance, and shall not be effective until 5520
the expiration of sixty days after their filing unless the 5521
superintendent sooner gives approval. The filing shall be 5522
accompanied by an actuarial certification in the form prescribed 5523
by the superintendent. The superintendent shall disapprove the 5524
filing, if the superintendent determines within the sixty-day 5525
period that the contractual periodic prepayment or premium rate, 5526
or amendment, is not in accordance with sound actuarial principles 5527
or is not reasonably related to the applicable coverage and5528
characteristics of the applicable class of enrollees. The5529
superintendent shall notify the health insuring corporation of the 5530
disapproval, and it shall thereafter be unlawful for the health 5531
insuring corporation to use the contractual periodic prepayment or 5532
premium rate, or amendment.5533

       (2) No contractual periodic prepayment for group policies for 5534
health care services shall be used until the contractual periodic 5535
prepayment has been filed with the superintendent. The filing 5536
shall be accompanied by an actuarial certification in the form 5537
prescribed by the superintendent. The superintendent may reject a 5538
filing made under division (A)(2) of this section at any time, 5539
with at least thirty days' written notice to a health insuring5540
corporation, if the contractual periodic prepayment is not in 5541
accordance with sound actuarial principles or is not reasonably 5542
related to the applicable coverage and characteristics of the 5543
applicable class of enrollees.5544

       (3) At any time, the superintendent, upon at least thirty5545
days' written notice to a health insuring corporation, may5546
withdraw the approval given under division (A)(1) of this section,5547
deemed or actual, of any contractual periodic prepayment or 5548
premium rate, or amendment, based on information that either of 5549
the following applies:5550

       (a) The contractual periodic prepayment or premium rate, or 5551
amendment, is not in accordance with sound actuarial principles.5552

       (b) The contractual periodic prepayment or premium rate, or 5553
amendment, is not reasonably related to the applicable coverage 5554
and characteristics of the applicable class of enrollees.5555

       (4) Any disapproval under division (A)(1) of this section,5556
any rejection of a filing made under division (A)(2) of this 5557
section, or any withdrawal of approval under division (A)(3) of 5558
this section, shall be effected by a written notice, which shall 5559
state the specific basis for the disapproval, rejection, or 5560
withdrawal and shall be issued in accordance with Chapter 119. of 5561
the Revised Code.5562

       (B) Notwithstanding division (A) of this section, a health 5563
insuring corporation may use a contractual periodic prepayment or 5564
premium rate for policies used for the coverage of beneficiaries 5565
enrolled in medicare pursuant to a medicare risk contract or5566
medicare cost contract, or for policies used for the coverage of5567
beneficiaries enrolled in the federal employees health benefits5568
program pursuant to 5 U.S.C.A. 8905, or for policies used for the 5569
coverage of medicaid recipients, or for policies used for 5570
coverage of participants of the children's buy-in program, or for 5571
policies used for the coverage of beneficiaries under any other 5572
federal health care program regulated by a federal regulatory 5573
body, or for policies used for the coverage of beneficiaries5574
under any contract covering officers or employees of the state5575
that has been entered into by the department of administrative 5576
services, if both of the following apply:5577

       (1) The contractual periodic prepayment or premium rate has 5578
been approved by the United States department of health and human 5579
services, the United States office of personnel management, the 5580
department of job and family serviceshealth care administration, 5581
or the department of administrative services.5582

       (2) The contractual periodic prepayment or premium rate is 5583
filed with the superintendent prior to use and is accompanied by5584
documentation of approval from the United States department of 5585
health and human services, the United States office of personnel 5586
management, the department of job and family serviceshealth care 5587
administration, or the department of administrative services.5588

       (C) The administrative expense portion of all contractual 5589
periodic prepayment or premium rate filings submitted to the 5590
superintendent for review must reflect the actual cost of 5591
administering the product. The superintendent may require that the 5592
administrative expense portion of the filings be itemized and 5593
supported.5594

       (D)(1) Copayments must be reasonable and must not be a 5595
barrier to the necessary utilization of services by enrollees.5596

       (2) A health insuring corporation, in order to ensure that 5597
copayments are reasonable and not a barrier to the necessary 5598
utilization of basic health care services by enrollees, may do one 5599
of the following:5600

       (a) Impose copayment charges on any single covered basic 5601
health care service that does not exceed forty per cent of the 5602
average cost to the health insuring corporation of providing the 5603
service;5604

       (b) Impose copayment charges that annually do not exceed 5605
twenty per cent of the total annual cost to the health insuring 5606
corporation of providing all covered basic health care services, 5607
including physician office visits, urgent care services, and 5608
emergency health services, when aggregated as to all persons 5609
covered under the filed product in question. In addition, annual 5610
copayment charges as to each enrollee shall not exceed twenty per 5611
cent of the total annual cost to the health insuring corporation 5612
of providing all covered basic health care services, including 5613
physician office visits, urgent care services, and emergency 5614
health services, as to such enrollee. The total annual cost of 5615
providing a health care service is the cost to the health insuring5616
corporation of providing the health care service to its enrollees5617
as reduced by any applicable provider discount.5618

       (3) To ensure that copayments are reasonable and not a 5619
barrier to the utilization of basic health care services, a health 5620
insuring corporation may not impose, in any contract year, on any5621
subscriber or enrollee, copayments that exceed two hundred per5622
cent of the average annual premium rate to subscribers or 5623
enrollees.5624

       (4) For purposes of division (D) of this section, both of the 5625
following apply:5626

        (a) Copayments imposed by health insuring corporations in 5627
connection with a high deductible health plan that is linked to a 5628
health savings account are reasonable and are not a barrier to the 5629
necessary utilization of services by enrollees.5630

        (b) Divisions (D)(2) and (3) of this section do not apply to 5631
a high deductible health plan that is linked to a health savings 5632
account.5633

       (E) A health insuring corporation shall not impose lifetime 5634
maximums on basic health care services. However, a health insuring 5635
corporation may establish a benefit limit for inpatient hospital 5636
services that are provided pursuant to a policy, contract, 5637
certificate, or agreement for supplemental health care services.5638

       (F) A health insuring corporation may require that an 5639
enrollee pay an annual deductible that does not exceed one 5640
thousand dollars per enrollee or two thousand dollars per family, 5641
except that:5642

       (1) A health insuring corporation may impose higher 5643
deductibles for high deductible health plans that are linked to 5644
health savings accounts;5645

       (2) The superintendent may adopt rules allowing different 5646
annual deductible amounts for plans with a medical savings 5647
account, health reimbursement arrangement, flexible spending 5648
account, or similar account;5649

       (3) A health insuring corporation may impose higher 5650
deductibles under health plans if requested by the group contract, 5651
policy, certificate, or agreement holder, or an individual seeking 5652
coverage under an individual health plan. This shall not be 5653
construed as requiring the health insuring corporation to create 5654
customized health plans for group contract holders or individuals.5655

        (G) As used in this section, "health savings account" and 5656
"high deductible health plan" have the same meanings as in the 5657
"Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C. 223, as 5658
amended.5659

       Sec. 1751.18.  (A)(1) No health insuring corporation shall 5660
cancel or fail to renew the coverage of a subscriber or enrollee 5661
because of any health status-related factor in relation to the 5662
subscriber or enrollee, the subscriber's or enrollee's 5663
requirements for health care services, or for any other reason 5664
designated under rules adopted by the superintendent of insurance.5665

       (2) Unless otherwise required by state or federal law, no5666
health insuring corporation, or health care facility or provider5667
through which the health insuring corporation has made5668
arrangements to provide health care services, shall discriminate5669
against any individual with regard to enrollment, disenrollment,5670
or the quality of health care services rendered, on the basis of5671
the individual's race, color, sex, age, religion, military status 5672
as defined in section 4112.01 of the Revised Code, or status as a 5673
recipient of medicare or medicaid, or any health status-related 5674
factor in relation to the individual. However, a health insuring 5675
corporation shall not be required to accept a recipient of 5676
medicare or medical assistancemedicaid, if an agreement has not 5677
been reached on appropriate payment mechanisms between the health 5678
insuring corporation and the governmental agency administering 5679
these programs. Further, except during a period of open 5680
enrollment under section 1751.15 of the Revised Code, a health 5681
insuring corporation may reject an applicant for nongroup 5682
enrollment on the basis of any health status-related factor in 5683
relation to the applicant.5684

       (B) A health insuring corporation may cancel or decide not to 5685
renew the coverage of an enrollee if the enrollee has performed an 5686
act or practice that constitutes fraud or intentional 5687
misrepresentation of material fact under the terms of the coverage 5688
and if the cancellation or nonrenewal is not based, either 5689
directly or indirectly, on any health status-related factor in 5690
relation to the enrollee.5691

       (C) An enrollee may appeal any action or decision of a health5692
insuring corporation taken pursuant to section 2742(b) to (e) of5693
the "Health Insurance Portability and Accountability Act of 1996," 5694
Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-42, as5695
amended. To appeal, the enrollee may submit a written complaint 5696
to the health insuring corporation pursuant to section 1751.19 of 5697
the Revised Code. The enrollee may, within thirty days after 5698
receiving a written response from the health insuring corporation, 5699
appeal the health insuring corporation's action or decision to the 5700
superintendent.5701

       (D) As used in this section, "health status-related factor"5702
means any of the following:5703

       (1) Health status;5704

       (2) Medical condition, including both physical and mental 5705
illnesses;5706

       (3) Claims experience;5707

       (4) Receipt of health care;5708

       (5) Medical history;5709

       (6) Genetic information;5710

       (7) Evidence of insurability, including conditions arising 5711
out of acts of domestic violence;5712

       (8) Disability.5713

       Sec. 1751.271.  (A) Each health insuring corporation that 5714
provides coverage to medicaid recipients shall post a performance 5715
bond in the amount of three million dollars as security to fulfill 5716
the obligations of the health insuring corporation to pay claims 5717
of contracted providers for covered health care services provided 5718
to medicaid recipients. The bond shall be payable to the 5719
department of insurance in the event that the health insuring 5720
corporation is placed in rehabilitation or liquidation proceedings 5721
under Chapter 3903. of the Revised Code, and shall become a 5722
special deposit subject to section 3903.14 or 3903.421 of the 5723
Revised Code, as applicable. In lieu of the performance bond, a 5724
medicaid health insuring corporation may deposit securities with 5725
the superintendent of insurance, acceptable to the superintendent, 5726
in the amount of three million dollars, to satisfy the bonding 5727
requirements of this section. Upon rehabilitation or liquidation, 5728
the securities shall become a special deposit subject to sections 5729
3903.14 and 3903.421 of the Revised Code, as applicable. The 5730
health insuring corporation shall receive the interest on the 5731
deposited securities as long as the health insuring corporation 5732
remains solvent.5733

        (B) The bond shall be issued by a surety company licensed 5734
with the department of insurance. The bond or deposit, or any 5735
replacement bond or deposit, shall be in a form acceptable to the 5736
superintendent, and shall remain in effect during the duration of 5737
the medicaid health insuring corporation's license and thereafter 5738
until all claims against the medicaid health insuring corporation 5739
have been paid in full.5740

        (C) Documentation of the bond acceptable to the 5741
superintendent of insurance shall be filed with the superintendent 5742
prior to the issuance of a certificate of authority. Annually, 5743
thirty days prior to the renewal of its certificate of authority, 5744
every medicaid health insuring corporation shall furnish the 5745
superintendent of insurance with evidence that the required bond 5746
is still in effect.5747

        (D) As used in this section:5748

        (1) "Contracted provider" means a provider that has a 5749
contract with a medicaid health insuring corporation to provide 5750
covered health care services to medicaid recipients.5751

        (2) "Medicaid health insuring corporation" means a health 5752
insuring corporation that provides health insurance coverage or 5753
otherwise assumes claims liabilities for medicaid recipients.5754

        (3) "Medicaid recipient" means a person eligible for medical5755
assistance under the medicaid program operated pursuant to Chapter 5756
5111. of the Revised Code.5757

       Sec. 1751.31.  (A) Any changes in a health insuring 5758
corporation's solicitation document shall be filed with the 5759
superintendent of insurance. The superintendent, within sixty days 5760
of filing, may disapprove any solicitation document or amendment 5761
to it on any of the grounds stated in this section. Such 5762
disapproval shall be effected by written notice to the health 5763
insuring corporation. The notice shall state the grounds for 5764
disapproval and shall be issued in accordance with Chapter 119. of5765
the Revised Code.5766

       (B) The solicitation document shall contain all information 5767
necessary to enable a consumer to make an informed choice as to 5768
whether or not to enroll in the health insuring corporation. The 5769
information shall include a specific description of the health 5770
care services to be available and the approximate number and type 5771
of full-time equivalent medical practitioners. The information 5772
shall be presented in the solicitation document in a manner that 5773
is clear, concise, and intelligible to prospective applicants in5774
the proposed service area.5775

       (C) Every potential applicant whose subscription to a health 5776
care plan is solicited shall receive, at or before the time of 5777
solicitation, a solicitation document approved by the 5778
superintendent.5779

       (D) Notwithstanding division (A) of this section, a health 5780
insuring corporation may use a solicitation document that the 5781
corporation uses in connection with policies for medicare5782
beneficiaries pursuant to a medicare risk contract or medicare 5783
cost contract, or for policies for beneficiaries of the federal 5784
employees health benefits program pursuant to 5 U.S.C.A. 8905, or 5785
for policies for medicaid recipients, or for policies for 5786
beneficiaries of any other federal health care program regulated 5787
by a federal regulatory body, or for policies for participants of 5788
the children's buy-in program, or for policies for beneficiaries 5789
of contracts covering officers or employees of the state entered 5790
into by the department of administrative services, if both of the 5791
following apply:5792

       (1) The solicitation document has been approved by the United5793
States department of health and human services, the United States 5794
office of personnel management, the department of job and family 5795
serviceshealth care administration, or the department of 5796
administrative services.5797

       (2) The solicitation document is filed with the5798
superintendent of insurance prior to use and is accompanied by5799
documentation of approval from the United States department of 5800
health and human services, the United States office of personnel5801
management, the department of job and family serviceshealth care 5802
administration, or the department of administrative services.5803

       (E) No health insuring corporation, or its agents or 5804
representatives, shall use monetary or other valuable 5805
consideration, engage in misleading or deceptive practices, or 5806
make untrue, misleading, or deceptive representations to induce 5807
enrollment. Nothing in this division shall prohibit incentive 5808
forms of remuneration such as commission sales programs for the 5809
health insuring corporation's employees and agents.5810

       (F) Any person obligated for any part of a premium rate in 5811
connection with an enrollment agreement, in addition to any right 5812
otherwise available to revoke an offer, may cancel such agreement 5813
within seventy-two hours after having signed the agreement or 5814
offer to enroll. Cancellation occurs when written notice of the 5815
cancellation is given to the health insuring corporation or its 5816
agents or other representatives. A notice of cancellation mailed 5817
to the health insuring corporation shall be considered to have 5818
been filed on its postmark date.5819

       (G) Nothing in this section shall prohibit healthy lifestyle 5820
programs.5821

       Sec. 1751.60.  (A) Except as provided for in divisions (E)5822
and (F) of this section, every provider or health care facility 5823
that contracts with a health insuring corporation to provide 5824
health care services to the health insuring corporation's 5825
enrollees or subscribers shall seek compensation for covered 5826
services solely from the health insuring corporation and not, 5827
under any circumstances, from the enrollees or subscribers, except 5828
for approved copayments and deductibles.5829

       (B) No subscriber or enrollee of a health insuring 5830
corporation is liable to any contracting provider or health care 5831
facility for the cost of any covered health care services, if the 5832
subscriber or enrollee has acted in accordance with the evidence 5833
of coverage.5834

       (C) Except as provided for in divisions (E) and (F) of this 5835
section, every contract between a health insuring corporation and 5836
provider or health care facility shall contain a provision 5837
approved by the superintendent of insurance requiring the provider 5838
or health care facility to seek compensation solely from the 5839
health insuring corporation and not, under any circumstances, from 5840
the subscriber or enrollee, except for approved copayments and 5841
deductibles.5842

       (D) Nothing in this section shall be construed as preventing 5843
a provider or health care facility from billing the enrollee or 5844
subscriber of a health insuring corporation for noncovered 5845
services.5846

       (E) Upon application by a health insuring corporation and a 5847
provider or health care facility, the superintendent may waive the 5848
requirements of divisions (A) and (C) of this section when, in5849
addition to the reserve requirements contained in section 1751.28 5850
of the Revised Code, the health insuring corporation provides 5851
sufficient assurances to the superintendent that the provider or 5852
health care facility has been provided with financial guarantees. 5853
No waiver of the requirements of divisions (A) and (C) of this 5854
section is effective as to enrollees or subscribers for whom the 5855
health insuring corporation is compensated under a provider 5856
agreement or risk contract entered into pursuant to Chapter 5111. 5857
or 5115. or 5168. of the Revised Code or under the children's 5858
buy-in program.5859

       (F) The requirements of divisions (A) to (C) of this section 5860
apply only to health care services provided to an enrollee or 5861
subscriber prior to the effective date of a termination of a 5862
contract between the health insuring corporation and the provider 5863
or health care facility.5864

       Sec. 1751.88.  Consistent with the Rules of Evidence, a 5865
written decision or opinion prepared by or for an independent 5866
review organization under section 1751.84 or 1751.85 of the 5867
Revised Code shall be admissible in any civil action related to 5868
the coverage decision that was the subject of the decision or 5869
opinion. The independent review organization's decision or opinion 5870
shall be presumed to be a scientifically valid and accurate 5871
description of the state of medical knowledge at the time it was 5872
written.5873

       Consistent with the Rules of Evidence, any party to a civil 5874
action related to a health insuring corporation's coverage 5875
decision involving an investigational or experimental drug, 5876
device, or treatment may introduce into evidence any applicable 5877
medicare reimbursement standards established under Title XVIII of5878
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 5879
as amendedmedicare program.5880

       Sec. 1751.89.  Sections 1751.77 to 1751.85 of the Revised 5881
Code do not apply to either of the following:5882

       (A) Coverage provided to beneficiaries enrolled in the5883
medicare+choice program operated under Title XVIII of the "Social5884
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended5885
the medicare program;5886

       (B) Coverage provided to medicaid recipients;5887

       (C) Coverage provided to participants of the children's 5888
buy-in program.5889

       Sec. 1923.14. (A) Except as otherwise provided in this5890
section, within ten days after receiving a writ of execution5891
described in division (A) or (B) of section 1923.13 of the Revised5892
Code, the sheriff, police officer, constable, or bailiff shall5893
execute it by restoring the plaintiff to the possession of the5894
premises, and shall levy and collect the costs and make return, as5895
upon other executions. If an appeal from the judgment of5896
restitution is filed and if, following the filing of the appeal, a5897
stay of execution is obtained and any required bond is filed with5898
the court of common pleas, municipal court, or county court, the5899
judge of that court immediately shall issue an order to the5900
sheriff, police officer, constable, or bailiff commanding the5901
delay of all further proceedings upon the execution. If the5902
premises have been restored to the plaintiff, the sheriff, police5903
officer, constable, or bailiff shall forthwith place the defendant5904
in possession of them, and return the writ with the sheriff's,5905
police officer's, constable's, or bailiff's proceedings and the5906
costs taxed on it.5907

       (B)(1) After a court of common pleas, municipal court, or5908
county court issues a writ of execution described in division (B)5909
of section 1923.13 of the Revised Code, the clerk of the court5910
shall send by regular mail, to the last known address of the5911
titled owner of the manufactured home, mobile home, or5912
recreational vehicle that is the subject of the writ and to the5913
last known address of each other person who is listed on the writ5914
as having any outstanding right, title, or interest in the home,5915
vehicle, or personal property and to the auditor and treasurer of 5916
the county in which the court is located, a written notice that5917
the home or vehicle potentially may be sold, destroyed, or have5918
its title transferred under the circumstances described in5919
division (B)(3) or (4) of this section.5920

       (2) Except as otherwise provided in this division, after 5921
receiving a writ of execution described in division (B) of 5922
section 1923.13 of the Revised Code, and after causing the5923
defendant to be removed from the residential premises of the5924
manufactured home park, if necessary, in accordance with the writ,5925
the sheriff, police officer, constable, or bailiff may cause the5926
manufactured home, mobile home, or recreational vehicle that is5927
the subject of the writ, and all personal property on the5928
residential premises, at the sheriff's, police officer's,5929
constable's, or bailiff's option, either to be removed from the5930
manufactured home park and, if necessary, moved to a storage5931
facility of the sheriff's, police officer's, constable's, or5932
bailiff's choice, or to be retained at their current location on5933
the residential premises, until they are claimed by the defendant 5934
or they are disposed of in a manner authorized by division (B)(3),5935
(4), or (6) of this section or by another section of the Revised 5936
Code. The sheriff, police officer, constable, or bailiff shall 5937
not cause the manufactured home, mobile home, or recreational 5938
vehicle that is the subject of the writ, or the personal 5939
property, to be removed from the manufactured home park or moved 5940
to a storage facility if the holder of any outstanding lien, 5941
right, title, or interest in the home or vehicle, other than the 5942
titled owner of the home or vehicle, meets the conditions set 5943
forth in division (B)(6) or (7) of this section.5944

       The sheriff, police officer, constable, or bailiff who5945
removes the manufactured home, mobile home, or recreational5946
vehicle, or the abandoned personal property, from the residential 5947
premises shall be immune from civil liability pursuant to section 5948
2744.03 of the Revised Code for any damage caused to the home, 5949
vehicle, or any personal property during the removal. The park 5950
operator shall not be liable for any damage caused by the park 5951
operator's removal of the manufactured home, mobile home, or 5952
recreational vehicle or the removal of the personal property 5953
from the residential premises, or for any damage to the home, 5954
vehicle, or personal property during the time the home, vehicle,5955
or property remains abandoned or stored in the manufactured home5956
park, unless the damage is the result of acts that the park5957
operator or the park operator's agents or employees performed 5958
with malicious purpose, in bad faith, or in a wanton or reckless5959
manner. The reasonable costs for a removal of the manufactured5960
home, mobile home, or recreational vehicle and personal property 5961
and, as applicable, the reasonable costs for its storage shall 5962
constitute a lien upon the home or vehicle payable by the titled5963
owner of the home or vehicle or payable pursuant to division5964
(B)(3) of this section.5965

       (3) Except as provided in divisions (B)(4), (5), and (6) of 5966
this section and division (D) of section 1923.12 of the Revised 5967
Code, within sixty days after receiving a writ of execution5968
described in division (B) of section 1923.13 of the Revised Code,5969
the sheriff, police officer, constable, or bailiff shall commence5970
proceedings for the sale of the manufactured home, mobile home, or5971
recreational vehicle that is the subject of the writ, and the 5972
abandoned personal property on the residential premises, if the 5973
home or vehicle is determined to be abandoned in accordance with 5974
the procedures for the sale of goods on execution under Chapter 5975
2329. of the Revised Code. In addition to all notices required to 5976
be given under section 2329.13 of the Revised Code, the sheriff, 5977
police officer, constable, or bailiff shall serve at their5978
respective last known addresses a written notice of the date, 5979
time, and place of the sale upon all persons who are listed on the 5980
writ of execution as having any outstanding right, title, or 5981
interest in the abandoned manufactured home, mobile home, or 5982
recreational vehicle and the personal property and shall provide 5983
written notice to the auditor and the treasurer of the county in 5984
which the court issuing the writ is located.5985

        Unless the proceedings are governed by division (D) of 5986
section 1923.12 of the Revised Code, notwithstanding any 5987
statutory provision to the contrary, including, but not limited 5988
to, section 2329.66 of the Revised Code, there shall be no stay of 5989
execution or exemption from levy or sale on execution available to 5990
the titled owner of the abandoned manufactured home, mobile home, 5991
or recreational vehicle in relation to a sale under this division. 5992
Except as otherwise provided in sections 2113.031, 2117.25, and 5993
5111.115162.40 of the Revised Code in a case involving a 5994
deceased resident or resident's estate, the sheriff, police5995
officer, constable, or bailiff shall distribute the proceeds 5996
from the sale of an abandoned manufactured home, mobile home, or5997
recreational vehicle and any personal property under this 5998
division in the following manner:5999

       (a) The sheriff, police officer, constable, or bailiff shall6000
first pay the costs for any moving of and any storage outside the6001
manufactured home park of the home or vehicle and any personal 6002
property pursuant to division (B)(2) of this section, the costs of 6003
the sale, including reimbursing the park operator for the deposit 6004
that the park operator paid to the clerk of court under division 6005
(C) of section 1923.12 of the Revised Code, and any unpaid court 6006
costs assessed against the defendant in the underlying action.6007

       (b) Following the payment required by division (B)(3)(a) of6008
this section, the sheriff, police officer, constable, or bailiff6009
shall pay all outstanding tax liens on the home or vehicle.6010

       (c) Following the payment required by division (B)(3)(b) of6011
this section, the sheriff, police officer, constable, or bailiff6012
shall pay all other outstanding security interests, liens, or6013
encumbrances on the home or vehicle by priority of filing or other6014
priority.6015

       (d) Following the payment required by division (B)(3)(c) of6016
this section, the sheriff, police officer, constable, or bailiff6017
shall pay any outstanding monetary judgment rendered under section6018
1923.09 or 1923.11 of the Revised Code in favor of the plaintiff6019
and any costs associated with retaining the home or vehicle prior6020
to the sale at its location on the residential premises within the6021
manufactured home park pursuant to division (B)(2) of this6022
section.6023

       (e) After complying with divisions (B)(3)(a) to (d) of this 6024
section, the sheriff, police officer, constable, or bailiff shall 6025
report any remaining money as unclaimed funds pursuant to Chapter 6026
169. of the Revised Code.6027

       Upon the return of any writ of execution for the satisfaction6028
of which an abandoned manufactured home, mobile home, or6029
recreational vehicle has been sold under this division, on careful6030
examination of the proceedings of the sheriff, police officer,6031
constable, or bailiff conducting the sale, if the court that6032
issued the writ finds that the sale was made, in all respects, in6033
conformity with the relevant provisions of Chapter 2329. of the6034
Revised Code and with this division, it shall direct the clerk of6035
the court to make an entry on the journal that the court is6036
satisfied with the legality of the sale and the court shall direct 6037
the clerk of the court of common pleas of the county in which the 6038
writ was issued to issue a certificate of title, free and clear of 6039
all security interests, liens, and encumbrances, to the purchaser 6040
of the home or vehicle. The clerk of the court of common pleas 6041
shall issue the new certificate of title to the purchaser of the 6042
home or vehicle regardless of whether the writ was issued by the 6043
court of common pleas or another court duly authorized to issue 6044
the writ. If the manufactured home, mobile home, or recreational 6045
vehicle sold under this division is located in a manufactured home 6046
park, the purchaser of the home or vehicle shall have no right to 6047
maintain the home or vehicle in the manufactured home park without 6048
the park operator's consent and the sheriff, police officer, 6049
constable, or bailiff conducting the sale shall notify all 6050
prospective purchasers of this fact prior to the commencement of 6051
the sale.6052

       If, after it is offered for sale on two occasions under this6053
division, the abandoned manufactured home, mobile home, or6054
recreational vehicle cannot be sold due to a want of bidders, the6055
sheriff, police officer, constable, or bailiff shall present the6056
writ of execution unsatisfied to the clerk of the court of common 6057
pleas of the county in which the writ was issued for the issuance 6058
by the clerk in the manner prescribed in section 4505.10 of the 6059
Revised Code of a certificate of title transferring the title of 6060
the home or vehicle to the plaintiff, free and clear of all 6061
security interests, liens, and encumbrances. The clerk of the 6062
court of common pleas shall issue the new certificate of title 6063
transferring the title of the manufactured home, mobile home, or 6064
recreational vehicle to the plaintiff regardless of whether the 6065
writ was issued by the court of common pleas or another court duly 6066
authorized to issue the writ. If any taxes are owed on the home or 6067
vehicle at this time, the county auditor shall remove the 6068
delinquent taxes from the manufactured home tax list and the 6069
delinquent manufactured home tax list and remit any penalties for 6070
late payment of manufactured home taxes. Acceptance of the 6071
certificate of title by the plaintiff terminates all further 6072
proceedings under this section.6073

       (4) Except as provided in division (B)(5) or (6) of this 6074
section and division (D) of section 1923.12 of the Revised Code,6075
within sixty days after receiving a writ of execution described in6076
division (B) of section 1923.13 of the Revised Code, if the6077
manufactured home, mobile home, or recreational vehicle is6078
determined to be abandoned and to have a value of less than three6079
thousand dollars, the sheriff, police officer, constable, or6080
bailiff shall serve at their respective last known addresses a6081
written notice of potential action as described in this division6082
upon all persons who are listed on the writ as having any6083
outstanding right, title, or interest in the home or vehicle. This6084
notice shall be in addition to all notices required to be given6085
under section 2329.13 of the Revised Code. Subject to the6086
fulfillment of these notice requirements, the sheriff, police6087
officer, constable, or bailiff shall take one of the following6088
actions with respect to the abandoned manufactured home, mobile6089
home, or recreational vehicle:6090

       (a) Cause its destruction if there is no person having an 6091
outstanding right, title, or interest in the home or vehicle, 6092
other than the titled owner of the home or vehicle;6093

       (b) Proceed with its sale under division (B)(3) of this6094
section;6095

       (c) If there is no person having an outstanding right, title, 6096
or interest in the home or vehicle other than the titled owner of 6097
the home or vehicle, or if there is an outstanding right, title, 6098
or interest in the home or vehicle and the lienholder consents in 6099
writing, present the writ of execution to the clerk of the court 6100
of common pleas of the county in which the writ was issued for 6101
the issuance by the clerk in the manner prescribed in section 6102
4505.10 of the Revised Code of a certificate of title 6103
transferring the title of the home or vehicle to the plaintiff, 6104
free and clear of all security interests, liens, and encumbrances. 6105
The clerk of the court of common pleas shall issue the new 6106
certificate of title transferring the title of the home or vehicle 6107
regardless of whether the writ was issued by the court of common 6108
pleas or another court duly authorized to issue the writ. If any 6109
taxes are owed on the home or vehicle at this time, the county 6110
auditor shall remove the delinquent taxes from the manufactured 6111
home tax list and the delinquent manufactured home tax list and 6112
remit any penalties for late payment of manufactured home taxes. 6113
Acceptance of the certificate of title by the plaintiff terminates 6114
all further proceedings under this section.6115

       (5) At any time prior to the issuance of the writ of6116
execution described in division (B) of section 1923.13 of the6117
Revised Code, the titled owner of the manufactured home, mobile6118
home, or recreational vehicle that would be the subject of the6119
writ may remove the abandoned home or vehicle from the6120
manufactured home park or other place of storage upon payment to6121
the county auditor of all outstanding tax liens on the home or6122
vehicle and, unless the owner is indigent, payment to the clerk of6123
court of all unpaid court costs assessed against the defendant in6124
the underlying action. After the issuance of the writ of6125
execution, the titled owner of the home or vehicle may remove the6126
abandoned home or vehicle from the manufactured home park or other6127
place of storage at any time up to the day before the scheduled6128
sale, destruction, or transfer of the home or vehicle pursuant to6129
division (B)(3) or (4) of this section upon payment of all of the6130
following:6131

        (a) All costs for moving and storage of the home or vehicle6132
pursuant to division (B)(2) of this section and all costs incurred6133
by the sheriff, police officer, constable, or bailiff up to and6134
including the date of the removal of the home or vehicle;6135

       (b) All outstanding tax liens on the home or vehicle;6136

       (c) Unless the owner is indigent, all unpaid court costs6137
assessed against the defendant in the underlying action.6138

       (6) At any time after the issuance of the writ of execution 6139
described in division (B) of section 1923.13 of the Revised Code, 6140
the holder of any outstanding lien, right, title, or interest in 6141
the manufactured home, mobile home, or recreational vehicle, other 6142
than the titled owner of the home or vehicle, may stop the 6143
sheriff, police officer, constable, or bailiff from proceeding 6144
with the sale under this division by doing both of the following:6145

        (a) Commencing a proceeding to repossess the home or vehicle 6146
pursuant to Chapters 1309. and 1317. of the Revised Code;6147

        (b) Paying to the park operator all monthly rental payments 6148
for the lot on which the home or vehicle is located from the time 6149
of the issuance of the writ of execution until the time that the 6150
home or vehicle is sold pursuant to Chapters 1309. and 1317. of 6151
the Revised Code.6152

       (7)(a) At any time prior to the day before the scheduled sale 6153
of the property pursuant to division (B)(3) of this section, the 6154
defendant may remove any personal property of the defendant from 6155
the abandoned home or vehicle or other place of storage.6156

       (b) If personal property owned by a person other than the 6157
defendant is abandoned on the residential premises and has not 6158
previously been removed, the owner of the personal property may 6159
remove the personal property from the abandoned home or vehicle or 6160
other place of storage up to the day before the scheduled sale of 6161
the property pursuant to division (B)(3) of this section upon 6162
presentation of proof of ownership of the property that is 6163
satisfactory to the sheriff, police officer, constable, or bailiff 6164
conducting the sale.6165

       Sec. 2113.041. (A) The administrator of the medicaid estate 6166
recovery program established pursuant to section 5111.115162.406167
of the Revised Code may present an affidavit to a financial 6168
institution requesting that the financial institution release 6169
account proceeds to recover the cost of services correctly 6170
provided to a medicaid recipient who is subject to the medicaid 6171
estate recovery program. The affidavit shall include all of the 6172
following information:6173

        (1) The name of the decedent;6174

        (2) The name of any person who gave notice that the decedent 6175
was a medicaid recipient and that person's relationship to the 6176
decedent;6177

        (3) The name of the financial institution;6178

        (4) The account number;6179

        (5) A description of the claim for estate recovery;6180

        (6) The amount of funds to be recovered.6181

        (B) A financial institution may release account proceeds to 6182
the administrator of the medicaid estate recovery program if all 6183
of the following apply:6184

        (1) The decedent held an account at the financial 6185
institution that was in the decedent's name only.6186

        (2) No estate has been, and it is reasonable to assume that 6187
no estate will be, opened for the decedent.6188

        (3) The decedent has no outstanding debts known to the 6189
administrator of the medicaid estate recovery program.6190

        (4) The financial institution has received no objections or 6191
has determined that no valid objections to release of proceeds 6192
have been received.6193

        (C) If proceeds have been released pursuant to division (B) 6194
of this section and the department of job and family services6195
health care administration receives notice of a valid claim to 6196
the proceeds that has a higher priority under section 2117.25 of 6197
the Revised Code than the claim of the medicaid estate recovery 6198
program, the department may refund the proceeds to the financial 6199
institution or pay them to the person or government entity with 6200
the claim.6201

       Sec. 2113.06.  Administration of the estate of an intestate6202
shall be granted to persons mentioned in this section, in the6203
following order:6204

       (A) To the surviving spouse of the deceased, if resident of6205
the state;6206

       (B) To one of the next of kin of the deceased, resident of6207
the state.6208

       If the persons entitled to administer the estate fail to take6209
or renounce administration voluntarily, they shall be cited by the6210
probate court for that purpose.6211

       If there are no persons entitled to administration, or if6212
they are for any reason unsuitable for the discharge of the trust,6213
or if without sufficient cause they neglect to apply within a6214
reasonable time for the administration of the estate, their right6215
to priority shall be lost, and the court shall commit the6216
administration to some suitable person who is a resident of the6217
state, or to the attorney general or the attorney general's6218
designee, if the department of job and family serviceshealth care 6219
administration is seeking to recover medical assistancemedicaid 6220
costs from the deceased pursuant to section 5111.115162.40 or 6221
5111.1115162.41 of the Revised Code. Such person may be a 6222
creditor of the estate.6223

       This section applies to the appointment of an administrator6224
de bonis non.6225

       Sec. 2117.061. (A) As used in this section:6226

       (1) "Medicaid estate recovery program" means the program 6227
instituted under section 5111.115162.40 of the Revised Code.6228

        (2) "Permanently institutionalized individual" has the same 6229
meaning as in section 5111.115162.40 of the Revised Code.6230

        (3) "Person responsible for the estate" means the executor, 6231
administrator, commissioner, or person who filed pursuant to 6232
section 2113.03 of the Revised Code for release from 6233
administration of an estate.6234

        (B) The person responsible for the estate of a decedent 6235
subject to the medicaid estate recovery program or the estate of 6236
a decedent who was the spouse of a decedent subject to the 6237
medicaid estate recovery program shall submit a properly 6238
completed medicaid estate recovery reporting form prescribed 6239
under division (D) of this section to the administrator of the 6240
medicaid estate recovery program not later than thirty days after 6241
the occurrence of any of the following:6242

        (1) The granting of letters testamentary;6243

        (2) The administration of the estate;6244

        (3) The filing of an application for release from 6245
administration or summary release from administration.6246

        (C) The person responsible for the estate shall mark the 6247
appropriate box on the appropriate probate form to indicate 6248
compliance with the requirements of division (B) of this section.6249

        The probate court shall send a copy of the completed probate 6250
form to the administrator of the medicaid estate recovery program.6251

       (D) The administrator of the medicaid estate recovery program 6252
shall prescribe a medicaid estate recovery reporting form for the 6253
purpose of division (B) of this section. In the case of a 6254
decedent subject to the medicaid estate recovery program, the form 6255
shall require, at a minimum, that the person responsible for the 6256
estate list all of the decedent's real and personal property and 6257
other assets that are part of the decedent's estate as defined in 6258
section 5111.115162.40 of the Revised Code. In the case of a 6259
decedent who was the spouse of a decedent subject to the medicaid 6260
estate recovery program, the form shall require, at a minimum, 6261
that the person responsible for the estate list all of the 6262
decedent's real and personal property and other assets that are 6263
part of the decedent's estate as defined in section 5111.116264
5162.40 of the Revised Code and were also part of the estate, as 6265
so defined, of the decedent subject to the medicaid estate 6266
recovery program. The administrator shall include on the form a 6267
statement printed in bold letters informing the person 6268
responsible for the estate that knowingly making a false 6269
statement on the form is falsification under section 2921.13 of 6270
the Revised Code, a misdemeanor of the first degree.6271

       (E) The administrator of the medicaid estate recovery 6272
program shall present a claim for estate recovery to the person 6273
responsible for the estate of the decedent or the person's legal 6274
representative not later than ninety days after the date on which 6275
the medicaid estate recovery reporting form is received under 6276
division (B) of this section or one year after the decedent's 6277
death, whichever is later.6278

       Sec. 2117.25. (A) Every executor or administrator shall6279
proceed with diligence to pay the debts of the decedent and shall6280
apply the assets in the following order:6281

       (1) Costs and expenses of administration;6282

       (2) An amount, not exceeding four thousand dollars, for6283
funeral expenses that are included in the bill of a funeral6284
director, funeral expenses other than those in the bill of a6285
funeral director that are approved by the probate court, and an6286
amount, not exceeding three thousand dollars, for burial and6287
cemetery expenses, including that portion of the funeral6288
director's bill allocated to cemetery expenses that have been paid6289
to the cemetery by the funeral director.6290

       For purposes of this division, burial and cemetery expenses6291
shall be limited to the following:6292

       (a) The purchase of a right of interment;6293

       (b) Monuments or other markers;6294

       (c) The outer burial container;6295

       (d) The cost of opening and closing the place of interment;6296

       (e) The urn.6297

       (3) The allowance for support made to the surviving spouse,6298
minor children, or both under section 2106.13 of the Revised Code;6299

       (4) Debts entitled to a preference under the laws of the6300
United States;6301

       (5) Expenses of the last sickness of the decedent;6302

       (6) If the total bill of a funeral director for funeral6303
expenses exceeds four thousand dollars, then, in addition to the6304
amount described in division (A)(2) of this section, an amount,6305
not exceeding two thousand dollars, for funeral expenses that are6306
included in the bill and that exceed four thousand dollars;6307

       (7) Personal property taxes, claims made under the medicaid 6308
estate recovery program instituted pursuant to section 5111.116309
5162.40 of the Revised Code, and obligations for which the6310
decedent was personally liable to the state or any of its6311
subdivisions;6312

       (8) Debts for manual labor performed for the decedent within6313
twelve months preceding the decedent's death, not exceeding three6314
hundred dollars to any one person;6315

       (9) Other debts for which claims have been presented and6316
finally allowed.6317

       (B) The part of the bill of a funeral director that exceeds6318
the total of six thousand dollars as described in divisions (A)(2) 6319
and (6) of this section, and the part of a claim included in 6320
division (A)(8) of this section that exceeds three hundred dollars 6321
shall be included as a debt under division (A)(9) of this section,6322
depending upon the time when the claim for the additional amount 6323
is presented.6324

       (C) Any natural person or fiduciary who pays a claim of any6325
creditor described in division (A) of this section shall be6326
subrogated to the rights of that creditor proportionate to the6327
amount of the payment and shall be entitled to reimbursement for6328
that amount in accordance with the priority of payments set forth6329
in that division.6330

       (D)(1) Chapters 2113. to 2125. of the Revised Code, relating6331
to the manner in which and the time within which claims shall be6332
presented, shall apply to claims set forth in divisions (A)(2),6333
(6), and (8) of this section. Claims for an expense of6334
administration or for the allowance for support need not be6335
presented. The executor or administrator shall pay debts included6336
in divisions (A)(4) and (7) of this section, of which the executor6337
or administrator has knowledge, regardless of presentation.6338

       (2) The giving of written notice to an executor or6339
administrator of a motion or application to revive an action6340
pending against the decedent at the date of death shall be6341
equivalent to the presentation of a claim to the executor or6342
administrator for the purpose of determining the order of payment6343
of any judgment rendered or decree entered in such an action.6344

       (E) No payments shall be made to creditors of one class until6345
all those of the preceding class are fully paid or provided for.6346
If the assets are insufficient to pay all the claims of one class, 6347
the creditors of that class shall be paid ratably.6348

       (F) If it appears at any time that the assets have been6349
exhausted in paying prior or preferred charges, allowances, or6350
claims, those payments shall be a bar to an action on any claim6351
not entitled to that priority or preference.6352

       Sec. 2133.01.  Unless the context otherwise requires, as used 6353
in sections 2133.01 to 2133.15 of the Revised Code:6354

       (A) "Adult" means an individual who is eighteen years of age 6355
or older.6356

       (B) "Attending physician" means the physician to whom a 6357
declarant or other patient, or the family of a declarant or other 6358
patient, has assigned primary responsibility for the treatment or 6359
care of the declarant or other patient, or, if the responsibility 6360
has not been assigned, the physician who has accepted that 6361
responsibility.6362

       (C) "Comfort care" means any of the following:6363

       (1) Nutrition when administered to diminish the pain or6364
discomfort of a declarant or other patient, but not to postpone6365
the declarant's or other patient's death;6366

       (2) Hydration when administered to diminish the pain or6367
discomfort of a declarant or other patient, but not to postpone6368
the declarant's or other patient's death;6369

       (3) Any other medical or nursing procedure, treatment,6370
intervention, or other measure that is taken to diminish the pain6371
or discomfort of a declarant or other patient, but not to postpone6372
the declarant's or other patient's death.6373

       (D) "Consulting physician" means a physician who, in6374
conjunction with the attending physician of a declarant or other6375
patient, makes one or more determinations that are required to be6376
made by the attending physician, or to be made by the attending6377
physician and one other physician, by an applicable provision of6378
this chapter, to a reasonable degree of medical certainty and in6379
accordance with reasonable medical standards.6380

       (E) "Declarant" means any adult who has executed a6381
declaration in accordance with section 2133.02 of the Revised6382
Code.6383

       (F) "Declaration" means a written document executed in6384
accordance with section 2133.02 of the Revised Code.6385

       (G) "Durable power of attorney for health care" means a6386
document created pursuant to sections 1337.11 to 1337.17 of the6387
Revised Code.6388

       (H) "Guardian" means a person appointed by a probate court6389
pursuant to Chapter 2111. of the Revised Code to have the care and 6390
management of the person of an incompetent.6391

       (I) "Health care facility" means any of the following:6392

       (1) A hospital;6393

       (2) A hospice care program or other institution that6394
specializes in comfort care of patients in a terminal condition or 6395
in a permanently unconscious state;6396

       (3) A nursing home or residential care facility, as defined 6397
in section 3721.01 of the Revised Code;6398

       (4) A home health agency and any residential facility where a 6399
person is receiving care under the direction of a home health 6400
agency;6401

       (5) An intermediate care facility for the mentally retarded.6402

       (J) "Health care personnel" means physicians, nurses,6403
physician assistants, emergency medical technicians-basic, 6404
emergency medical technicians-intermediate, emergency medical 6405
technicians-paramedic, medical technicians, dietitians, other 6406
authorized persons acting under the direction of an attending 6407
physician, and administrators of health care facilities.6408

       (K) "Home health agency" has the same meaning as in section 6409
3701.881 of the Revised Code.6410

       (L) "Hospice care program" has the same meaning as in section 6411
3712.01 of the Revised Code.6412

       (M) "Hospital" has the same meanings as in sections 3701.01, 6413
3727.01, and 5122.01 of the Revised Code.6414

       (N) "Hydration" means fluids that are artificially or6415
technologically administered.6416

       (O) "Incompetent" has the same meaning as in section 2111.01 6417
of the Revised Code.6418

       (P) "Intermediate care facility for the mentally retarded"6419
has the same meaning as in section 5111.205164.01 of the Revised 6420
Code.6421

       (Q) "Life-sustaining treatment" means any medical procedure, 6422
treatment, intervention, or other measure that, when administered 6423
to a qualified patient or other patient, will serve principally to 6424
prolong the process of dying.6425

       (R) "Nurse" means a person who is licensed to practice6426
nursing as a registered nurse or to practice practical nursing as6427
a licensed practical nurse pursuant to Chapter 4723. of the6428
Revised Code.6429

       (S) "Nursing home" has the same meaning as in section 3721.01 6430
of the Revised Code.6431

       (T) "Nutrition" means sustenance that is artificially or6432
technologically administered.6433

       (U) "Permanently unconscious state" means a state of6434
permanent unconsciousness in a declarant or other patient that, to 6435
a reasonable degree of medical certainty as determined in6436
accordance with reasonable medical standards by the declarant's or 6437
other patient's attending physician and one other physician who 6438
has examined the declarant or other patient, is characterized by 6439
both of the following:6440

       (1) Irreversible unawareness of one's being and environment.6441

       (2) Total loss of cerebral cortical functioning, resulting in 6442
the declarant or other patient having no capacity to experience 6443
pain or suffering.6444

       (V) "Person" has the same meaning as in section 1.59 of the 6445
Revised Code and additionally includes political subdivisions and 6446
governmental agencies, boards, commissions, departments,6447
institutions, offices, and other instrumentalities.6448

       (W) "Physician" means a person who is authorized under6449
Chapter 4731. of the Revised Code to practice medicine and surgery 6450
or osteopathic medicine and surgery.6451

       (X) "Political subdivision" and "state" have the same6452
meanings as in section 2744.01 of the Revised Code.6453

       (Y) "Professional disciplinary action" means action taken by 6454
the board or other entity that regulates the professional conduct 6455
of health care personnel, including the state medical board and 6456
the board of nursing.6457

       (Z) "Qualified patient" means an adult who has executed a6458
declaration and has been determined to be in a terminal condition6459
or in a permanently unconscious state.6460

       (AA) "Terminal condition" means an irreversible, incurable, 6461
and untreatable condition caused by disease, illness, or injury 6462
from which, to a reasonable degree of medical certainty as 6463
determined in accordance with reasonable medical standards by a 6464
declarant's or other patient's attending physician and one other 6465
physician who has examined the declarant or other patient, both of 6466
the following apply:6467

       (1) There can be no recovery.6468

       (2) Death is likely to occur within a relatively short time 6469
if life-sustaining treatment is not administered.6470

       (BB) "Tort action" means a civil action for damages for6471
injury, death, or loss to person or property, other than a civil6472
action for damages for breach of a contract or another agreement6473
between persons.6474

       Sec. 2151.3514.  (A) As used in this section:6475

       (1) "Alcohol and drug addiction program" has the same meaning 6476
as in section 3793.01 of the Revised Code;6477

       (2) "Chemical dependency" means either of the following:6478

       (a) The chronic and habitual use of alcoholic beverages to 6479
the extent that the user no longer can control the use of alcohol 6480
or endangers the user's health, safety, or welfare or that of 6481
others;6482

       (b) The use of a drug of abuse to the extent that the user 6483
becomes physically or psychologically dependent on the drug or 6484
endangers the user's health, safety, or welfare or that of others.6485

       (3) "Drug of abuse" has the same meaning as in section 6486
3719.011 of the Revised Code.6487

       (4) "Medicaid" means the program established under Chapter 6488
5111. of the Revised Code.6489

       (B) If the juvenile court issues an order of temporary 6490
custody or protective supervision under division (A) of section 6491
2151.353 of the Revised Code with respect to a child adjudicated 6492
to be an abused, neglected, or dependent child and the alcohol or 6493
other drug addiction of a parent or other caregiver of the child 6494
was the basis for the adjudication of abuse, neglect, or 6495
dependency, the court shall issue an order requiring the parent or 6496
other caregiver to submit to an assessment and, if needed, 6497
treatment from an alcohol and drug addiction program certified by 6498
the department of alcohol and drug addiction services. The court 6499
may order the parent or other caregiver to submit to alcohol or 6500
other drug testing during, after, or both during and after, the 6501
treatment. The court shall send any order issued pursuant to this 6502
division to the public children services agency that serves the 6503
county in which the court is located for use as described in 6504
section 340.15 of the Revised Code.6505

       (C) Any order requiring alcohol or other drug testing that is 6506
issued pursuant to division (B) of this section shall require one 6507
alcohol or other drug test to be conducted each month during a 6508
period of twelve consecutive months beginning the month 6509
immediately following the month in which the order for alcohol or 6510
other drug testing is issued. Arrangements for administering the 6511
alcohol or other drug tests, as well as funding the costs of the 6512
tests, shall be locally determined in accordance with sections 6513
340.033 and 340.15 of the Revised Code. If a parent or other 6514
caregiver required to submit to alcohol or other drug tests under 6515
this section is not a recipient of medicaid, the agency that 6516
refers the parent or caregiver for the tests may require the 6517
parent or caregiver to reimburse the agency for the cost of6518
conducting the tests.6519

       (D) The certified alcohol and drug addiction program that 6520
conducts any alcohol or other drug tests ordered in accordance 6521
with divisions (B) and (C) of this section shall send the results 6522
of the tests, along with the program's recommendations as to the 6523
benefits of continued treatment, to the court and to the public 6524
children services agency providing services to the involved 6525
family, according to federal regulations set forth in 42 C.F.R.6526
Part 2, and division (B) of section 340.15 of the Revised Code. 6527
The court shall consider the results and the recommendations sent 6528
to it under this division in any adjudication or review by the 6529
court, according to section 2151.353, 2151.414, or 2151.419 of the 6530
Revised Code.6531

       Sec. 2305.234.  (A) As used in this section:6532

       (1) "Chiropractic claim," "medical claim," and "optometric6533
claim" have the same meanings as in section 2305.113 of the 6534
Revised Code.6535

       (2) "Dental claim" has the same meaning as in section 6536
2305.113 of the Revised Code, except that it does not include any6537
claim arising out of a dental operation or any derivative claim6538
for relief that arises out of a dental operation.6539

       (3) "Governmental health care program" has the same meaning6540
as in section 4731.65 of the Revised Code.6541

       (4) "Health care facility or location" means a hospital, 6542
clinic, ambulatory surgical facility, office of a health care 6543
professional or associated group of health care professionals, 6544
training institution for health care professionals, or any other 6545
place where medical, dental, or other health-related diagnosis, 6546
care, or treatment is provided to a person.6547

       (5) "Health care professional" means any of the following who6548
provide medical, dental, or other health-related diagnosis, care,6549
or treatment:6550

       (a) Physicians authorized under Chapter 4731. of the Revised6551
Code to practice medicine and surgery or osteopathic medicine and6552
surgery;6553

       (b) Registered nurses and licensed practical nurses licensed6554
under Chapter 4723. of the Revised Code and individuals who hold a 6555
certificate of authority issued under that chapter that authorizes 6556
the practice of nursing as a certified registered nurse 6557
anesthetist, clinical nurse specialist, certified nurse-midwife, 6558
or certified nurse practitioner;6559

       (c) Physician assistants authorized to practice under Chapter 6560
4730. of the Revised Code;6561

       (d) Dentists and dental hygienists licensed under Chapter6562
4715. of the Revised Code;6563

       (e) Physical therapists, physical therapist assistants, 6564
occupational therapists, and occupational therapy assistants 6565
licensed under Chapter 4755. of the Revised Code;6566

       (f) Chiropractors licensed under Chapter 4734. of the Revised 6567
Code;6568

       (g) Optometrists licensed under Chapter 4725. of the Revised6569
Code;6570

       (h) Podiatrists authorized under Chapter 4731. of the Revised 6571
Code to practice podiatry;6572

       (i) Dietitians licensed under Chapter 4759. of the Revised6573
Code;6574

       (j) Pharmacists licensed under Chapter 4729. of the Revised6575
Code;6576

       (k) Emergency medical technicians-basic, emergency medical6577
technicians-intermediate, and emergency medical6578
technicians-paramedic, certified under Chapter 4765. of the6579
Revised Code;6580

       (l) Respiratory care professionals licensed under Chapter 6581
4761. of the Revised Code;6582

       (m) Speech-language pathologists and audiologists licensed 6583
under Chapter 4753. of the Revised Code.6584

       (6) "Health care worker" means a person other than a health6585
care professional who provides medical, dental, or other6586
health-related care or treatment under the direction of a health6587
care professional with the authority to direct that individual's6588
activities, including medical technicians, medical assistants,6589
dental assistants, orderlies, aides, and individuals acting in6590
similar capacities.6591

       (7) "Indigent and uninsured person" means a person who meets6592
all of the following requirements:6593

       (a) The person's income is not greater than two hundred per6594
cent of the current poverty line as defined by the United States 6595
office of management and budget and revised in accordance with 6596
section 673(2) of the "Omnibus Budget Reconciliation Act of 1981," 6597
95 Stat. 511, 42 U.S.C. 9902, as amended.6598

       (b) The person is not eligible to receive medical assistance6599
under Chapter 5111.ineligible for the medicaid program, the6600
disability medical assistance under Chapter 5115. of the Revised 6601
Code orprogram, and assistance under any other governmental 6602
health care program.6603

       (c) Either of the following applies:6604

       (i) The person is not a policyholder, certificate holder,6605
insured, contract holder, subscriber, enrollee, member,6606
beneficiary, or other covered individual under a health insurance6607
or health care policy, contract, or plan.6608

       (ii) The person is a policyholder, certificate holder,6609
insured, contract holder, subscriber, enrollee, member,6610
beneficiary, or other covered individual under a health insurance6611
or health care policy, contract, or plan, but the insurer, policy,6612
contract, or plan denies coverage or is the subject of insolvency6613
or bankruptcy proceedings in any jurisdiction.6614

       (8) "Nonprofit health care referral organization" means an 6615
entity that is not operated for profit and refers patients to, or 6616
arranges for the provision of, health-related diagnosis, care, or 6617
treatment by a health care professional or health care worker.6618

       (9) "Operation" means any procedure that involves cutting or6619
otherwise infiltrating human tissue by mechanical means, including6620
surgery, laser surgery, ionizing radiation, therapeutic6621
ultrasound, or the removal of intraocular foreign bodies.6622
"Operation" does not include the administration of medication by6623
injection, unless the injection is administered in conjunction6624
with a procedure infiltrating human tissue by mechanical means6625
other than the administration of medicine by injection. 6626
"Operation" does not include routine dental restorative 6627
procedures, the scaling of teeth, or extractions of teeth that are 6628
not impacted.6629

       (10) "Tort action" means a civil action for damages for6630
injury, death, or loss to person or property other than a civil6631
action for damages for a breach of contract or another agreement6632
between persons or government entities.6633

       (11) "Volunteer" means an individual who provides any6634
medical, dental, or other health-care related diagnosis, care, or6635
treatment without the expectation of receiving and without receipt6636
of any compensation or other form of remuneration from an indigent6637
and uninsured person, another person on behalf of an indigent and6638
uninsured person, any health care facility or location, any 6639
nonprofit health care referral organization, or any other person 6640
or government entity.6641

       (12) "Community control sanction" has the same meaning as in 6642
section 2929.01 of the Revised Code.6643

       (13) "Deep sedation" means a drug-induced depression of 6644
consciousness during which a patient cannot be easily aroused but 6645
responds purposefully following repeated or painful stimulation, a 6646
patient's ability to independently maintain ventilatory function 6647
may be impaired, a patient may require assistance in maintaining a 6648
patent airway and spontaneous ventilation may be inadequate, and 6649
cardiovascular function is usually maintained.6650

       (14) "General anesthesia" means a drug-induced loss of 6651
consciousness during which a patient is not arousable, even by 6652
painful stimulation, the ability to independently maintain 6653
ventilatory function is often impaired, a patient often requires 6654
assistance in maintaining a patent airway, positive pressure 6655
ventilation may be required because of depressed spontaneous 6656
ventilation or drug-induced depression of neuromuscular function, 6657
and cardiovascular function may be impaired.6658

       (B)(1) Subject to divisions (F) and (G)(3) of this section, a 6659
health care professional who is a volunteer and complies with6660
division (B)(2) of this section is not liable in damages to any6661
person or government entity in a tort or other civil action,6662
including an action on a medical, dental, chiropractic,6663
optometric, or other health-related claim, for injury, death, or6664
loss to person or property that allegedly arises from an action or6665
omission of the volunteer in the provision to an indigent and 6666
uninsured person of medical, dental, or other health-related 6667
diagnosis, care, or treatment, including the provision of samples 6668
of medicine and other medical products, unless the action or 6669
omission constitutes willful or wanton misconduct.6670

       (2) To qualify for the immunity described in division (B)(1)6671
of this section, a health care professional shall do all of the6672
following prior to providing diagnosis, care, or treatment:6673

       (a) Determine, in good faith, that the indigent and uninsured6674
person is mentally capable of giving informed consent to the 6675
provision of the diagnosis, care, or treatment and is not subject 6676
to duress or under undue influence;6677

       (b) Inform the person of the provisions of this section, 6678
including notifying the person that, by giving informed consent to 6679
the provision of the diagnosis, care, or treatment, the person 6680
cannot hold the health care professional liable for damages in a 6681
tort or other civil action, including an action on a medical, 6682
dental, chiropractic, optometric, or other health-related claim, 6683
unless the action or omission of the health care professional 6684
constitutes willful or wanton misconduct;6685

       (c) Obtain the informed consent of the person and a written6686
waiver, signed by the person or by another individual on behalf of6687
and in the presence of the person, that states that the person is6688
mentally competent to give informed consent and, without being6689
subject to duress or under undue influence, gives informed consent6690
to the provision of the diagnosis, care, or treatment subject to6691
the provisions of this section. A written waiver under division 6692
(B)(2)(c) of this section shall state clearly and in conspicuous 6693
type that the person or other individual who signs the waiver is 6694
signing it with full knowledge that, by giving informed consent to 6695
the provision of the diagnosis, care, or treatment, the person 6696
cannot bring a tort or other civil action, including an action on 6697
a medical, dental, chiropractic, optometric, or other 6698
health-related claim, against the health care professional unless 6699
the action or omission of the health care professional constitutes 6700
willful or wanton misconduct.6701

       (3) A physician or podiatrist who is not covered by medical6702
malpractice insurance, but complies with division (B)(2) of this6703
section, is not required to comply with division (A) of section6704
4731.143 of the Revised Code.6705

       (C) Subject to divisions (F) and (G)(3) of this section,6706
health care workers who are volunteers are not liable in damages6707
to any person or government entity in a tort or other civil6708
action, including an action upon a medical, dental, chiropractic,6709
optometric, or other health-related claim, for injury, death, or6710
loss to person or property that allegedly arises from an action or6711
omission of the health care worker in the provision to an indigent 6712
and uninsured person of medical, dental, or other health-related 6713
diagnosis, care, or treatment, unless the action or omission 6714
constitutes willful or wanton misconduct.6715

       (D) Subject to divisions (F) and (G)(3) of this section, a 6716
nonprofit health care referral organization is not liable in 6717
damages to any person or government entity in a tort or other 6718
civil action, including an action on a medical, dental, 6719
chiropractic, optometric, or other health-related claim, for 6720
injury, death, or loss to person or property that allegedly arises 6721
from an action or omission of the nonprofit health care referral 6722
organization in referring indigent and uninsured persons to, or 6723
arranging for the provision of, medical, dental, or other 6724
health-related diagnosis, care, or treatment by a health care 6725
professional described in division (B)(1) of this section or a 6726
health care worker described in division (C) of this section, 6727
unless the action or omission constitutes willful or wanton 6728
misconduct.6729

       (E) Subject to divisions (F) and (G)(3) of this section and6730
to the extent that the registration requirements of section 6731
3701.071 of the Revised Code apply, a health care facility or 6732
location associated with a health care professional described in 6733
division (B)(1) of this section, a health care worker described in 6734
division (C) of this section, or a nonprofit health care referral 6735
organization described in division (D) of this section is not 6736
liable in damages to any person or government entity in a tort or 6737
other civil action, including an action on a medical, dental,6738
chiropractic, optometric, or other health-related claim, for6739
injury, death, or loss to person or property that allegedly arises6740
from an action or omission of the health care professional or6741
worker or nonprofit health care referral organization relative to 6742
the medical, dental, or other health-related diagnosis, care, or 6743
treatment provided to an indigent and uninsured person on behalf 6744
of or at the health care facility or location, unless the action 6745
or omission constitutes willful or wanton misconduct.6746

       (F)(1) Except as provided in division (F)(2) of this section, 6747
the immunities provided by divisions (B), (C), (D), and (E) of6748
this section are not available to a health care professional, 6749
health care worker, nonprofit health care referral organization, 6750
or health care facility or location if, at the time of an alleged6751
injury, death, or loss to person or property, the health care 6752
professionals or health care workers involved are providing one of 6753
the following:6754

       (a) Any medical, dental, or other health-related diagnosis,6755
care, or treatment pursuant to a community service work order6756
entered by a court under division (B) of section 2951.02 of the6757
Revised Code or imposed by a court as a community control6758
sanction;6759

       (b) Performance of an operation to which any one of the 6760
following applies:6761

        (i) The operation requires the administration of deep 6762
sedation or general anesthesia.6763

        (ii) The operation is a procedure that is not typically 6764
performed in an office.6765

       (iii) The individual involved is a health care professional, 6766
and the operation is beyond the scope of practice or the 6767
education, training, and competence, as applicable, of the health 6768
care professional.6769

       (c) Delivery of a baby or any other purposeful termination of 6770
a human pregnancy.6771

       (2) Division (F)(1) of this section does not apply when a 6772
health care professional or health care worker provides medical, 6773
dental, or other health-related diagnosis, care, or treatment that 6774
is necessary to preserve the life of a person in a medical 6775
emergency.6776

       (G)(1) This section does not create a new cause of action or6777
substantive legal right against a health care professional, health6778
care worker, nonprofit health care referral organization, or 6779
health care facility or location.6780

       (2) This section does not affect any immunities from civil6781
liability or defenses established by another section of the6782
Revised Code or available at common law to which a health care 6783
professional, health care worker, nonprofit health care referral 6784
organization, or health care facility or location may be entitled 6785
in connection with the provision of emergency or other medical, 6786
dental, or other health-related diagnosis, care, or treatment.6787

       (3) This section does not grant an immunity from tort or6788
other civil liability to a health care professional, health care 6789
worker, nonprofit health care referral organization, or health6790
care facility or location for actions that are outside the scope 6791
of authority of health care professionals or health care workers.6792

       (4) This section does not affect any legal responsibility of6793
a health care professional, health care worker, or nonprofit 6794
health care referral organization to comply with any applicable 6795
law of this state or rule of an agency of this state.6796

       (5) This section does not affect any legal responsibility of6797
a health care facility or location to comply with any applicable 6798
law of this state, rule of an agency of this state, or local code, 6799
ordinance, or regulation that pertains to or regulates building, 6800
housing, air pollution, water pollution, sanitation, health, fire, 6801
zoning, or safety.6802

       Sec. 2307.65. (A) The attorney general may bring a civil 6803
action in the Franklin county court of common pleas on behalf of 6804
the department of job and family serviceshealth care 6805
administration, and the prosecuting attorney of the county in 6806
which a violation of division (B) of section 2913.401 of the 6807
Revised Code occurs may bring a civil action in the court of 6808
common pleas of that county on behalf of the county department of 6809
job and family services, against a person who violates division 6810
(B) of section 2913.401 of the Revised Code for the recovery of 6811
the amount of benefits paid on behalf of a person that either 6812
department would not have paid but for the violation minus any 6813
amounts paid in restitution under division (C)(2) of section 6814
2913.401 of the Revised Code and for reasonable attorney's fees 6815
and all other fees and costs of litigation.6816

        (B) In a civil action brought under division (A) of this 6817
section, if the defendant failed to disclose a transfer of 6818
property in violation of division (B)(3) of section 2913.401 of 6819
the Revised Code, the court may also grant any of the following 6820
relief to the extent permitted by 42 U.S.C. 1396p:6821

        (1) Avoidance of the transfer of property that was not 6822
disclosed in violation of division (B)(3) of section 2913.401 of 6823
the Revised Code to the extent of the amount of benefits the 6824
department would not have paid but for the violation;6825

        (2) An order of attachment or garnishment against the 6826
property in accordance with Chapter 2715. or 2716. of the Revised 6827
Code;6828

        (3) An injunction against any further disposition by the 6829
transferor or transferee, or both, of the property the transfer of 6830
which was not disclosed in violation of division (B)(3) of section 6831
2913.401 of the Revised Code or against the disposition of other 6832
property by the transferor or transferee;6833

        (4) Appointment of a receiver to take charge of the property 6834
transferred or of other property of the transferee;6835

        (5) Any other relief that the court considers just and 6836
equitable.6837

        (C) To the extent permitted by 42 U.S.C. 1396p, the 6838
department of job and family serviceshealth care administration6839
or the county department of job and family services may enforce a 6840
judgment obtained under this section by levying on property the 6841
transfer of which was not disclosed in violation of division 6842
(B)(3) of section 2913.401 of the Revised Code or on the proceeds 6843
of the transfer of that property in accordance with Chapter 2329. 6844
of the Revised Code.6845

        (D) The remedies provided in divisions (B) and (C) of this 6846
section do not apply if the transferee of the property the 6847
transfer of which was not disclosed in violation of division 6848
(B)(3) of section 2913.401 of the Revised Code acquired the 6849
property in good faith and for fair market value.6850

        (E) The remedies provided in this section are not exclusive 6851
and do not preclude the use of any other criminal or civil remedy 6852
for any act that is in violation of section 2913.401 of the 6853
Revised Code.6854

        (F) Amounts of medicaid benefits paid and recovered in an 6855
action brought under this section shall be credited to the general 6856
revenue fund, and any applicable federal share shall be returned 6857
to the appropriate agency or department of the United States.6858

       Sec. 2317.02.  The following persons shall not testify in6859
certain respects:6860

       (A)(1) An attorney, concerning a communication made to the6861
attorney by a client in that relation or the attorney's advice to6862
a client, except that the attorney may testify by express consent6863
of the client or, if the client is deceased, by the express6864
consent of the surviving spouse or the executor or administrator6865
of the estate of the deceased client. However, if the client 6866
voluntarily testifies or is deemed by section 2151.421 of the 6867
Revised Code to have waived any testimonial privilege under this 6868
division, the attorney may be compelled to testify on the same 6869
subject.6870

       The testimonial privilege established under this division 6871
does not apply concerning a communication between a client who has 6872
since died and the deceased client's attorney if the communication 6873
is relevant to a dispute between parties who claim through that 6874
deceased client, regardless of whether the claims are by testate 6875
or intestate succession or by inter vivos transaction, and the 6876
dispute addresses the competency of the deceased client when the 6877
deceased client executed a document that is the basis of the 6878
dispute or whether the deceased client was a victim of fraud, 6879
undue influence, or duress when the deceased client executed a 6880
document that is the basis of the dispute.6881

       (2) An attorney, concerning a communication made to the 6882
attorney by a client in that relationship or the attorney's advice 6883
to a client, except that if the client is an insurance company, 6884
the attorney may be compelled to testify, subject to an in camera 6885
inspection by a court, about communications made by the client to 6886
the attorney or by the attorney to the client that are related to 6887
the attorney's aiding or furthering an ongoing or future 6888
commission of bad faith by the client, if the party seeking 6889
disclosure of the communications has made a prima facie showing of 6890
bad faith, fraud, or criminal misconduct by the client.6891

       (B)(1) A physician or a dentist concerning a communication6892
made to the physician or dentist by a patient in that relation or6893
the physician's or dentist's advice to a patient, except as6894
otherwise provided in this division, division (B)(2), and division6895
(B)(3) of this section, and except that, if the patient is deemed6896
by section 2151.421 of the Revised Code to have waived any6897
testimonial privilege under this division, the physician may be6898
compelled to testify on the same subject.6899

       The testimonial privilege established under this division6900
does not apply, and a physician or dentist may testify or may be6901
compelled to testify, in any of the following circumstances:6902

       (a) In any civil action, in accordance with the discovery6903
provisions of the Rules of Civil Procedure in connection with a6904
civil action, or in connection with a claim under Chapter 4123. of6905
the Revised Code, under any of the following circumstances:6906

       (i) If the patient or the guardian or other legal6907
representative of the patient gives express consent;6908

       (ii) If the patient is deceased, the spouse of the patient or 6909
the executor or administrator of the patient's estate gives6910
express consent;6911

       (iii) If a medical claim, dental claim, chiropractic claim,6912
or optometric claim, as defined in section 2305.113 of the Revised6913
Code, an action for wrongful death, any other type of civil6914
action, or a claim under Chapter 4123. of the Revised Code is6915
filed by the patient, the personal representative of the estate of6916
the patient if deceased, or the patient's guardian or other legal6917
representative.6918

       (b) In any civil action concerning court-ordered treatment or 6919
services received by a patient, if the court-ordered treatment or 6920
services were ordered as part of a case plan journalized under6921
section 2151.412 of the Revised Code or the court-ordered6922
treatment or services are necessary or relevant to dependency,6923
neglect, or abuse or temporary or permanent custody proceedings6924
under Chapter 2151. of the Revised Code.6925

       (c) In any criminal action concerning any test or the results 6926
of any test that determines the presence or concentration of 6927
alcohol, a drug of abuse, a combination of them, a controlled 6928
substance, or a metabolite of a controlled substance in the 6929
patient's whole blood, blood serum or plasma, breath, urine, or 6930
other bodily substance at any time relevant to the criminal 6931
offense in question.6932

       (d) In any criminal action against a physician or dentist. In 6933
such an action, the testimonial privilege established under this 6934
division does not prohibit the admission into evidence, in6935
accordance with the Rules of Evidence, of a patient's medical or6936
dental records or other communications between a patient and the6937
physician or dentist that are related to the action and obtained6938
by subpoena, search warrant, or other lawful means. A court that6939
permits or compels a physician or dentist to testify in such an6940
action or permits the introduction into evidence of patient6941
records or other communications in such an action shall require6942
that appropriate measures be taken to ensure that the6943
confidentiality of any patient named or otherwise identified in6944
the records is maintained. Measures to ensure confidentiality that 6945
may be taken by the court include sealing its records or deleting 6946
specific information from its records.6947

       (e)(i) If the communication was between a patient who has 6948
since died and the deceased patient's physician or dentist, the 6949
communication is relevant to a dispute between parties who claim 6950
through that deceased patient, regardless of whether the claims 6951
are by testate or intestate succession or by inter vivos 6952
transaction, and the dispute addresses the competency of the 6953
deceased patient when the deceased patient executed a document 6954
that is the basis of the dispute or whether the deceased patient 6955
was a victim of fraud, undue influence, or duress when the 6956
deceased patient executed a document that is the basis of the 6957
dispute.6958

       (ii) If neither the spouse of a patient nor the executor or 6959
administrator of that patient's estate gives consent under 6960
division (B)(1)(a)(ii) of this section, testimony or the 6961
disclosure of the patient's medical records by a physician, 6962
dentist, or other health care provider under division (B)(1)(e)(i) 6963
of this section is a permitted use or disclosure of protected 6964
health information, as defined in 45 C.F.R. 160.103, and an 6965
authorization or opportunity to be heard shall not be required.6966

       (iii) Division (B)(1)(e)(i) of this section does not require 6967
a mental health professional to disclose psychotherapy notes, as 6968
defined in 45 C.F.R. 164.501.6969

       (iv) An interested person who objects to testimony or 6970
disclosure under division (B)(1)(e)(i) of this section may seek a 6971
protective order pursuant to Civil Rule 26.6972

       (v) A person to whom protected health information is 6973
disclosed under division (B)(1)(e)(i) of this section shall not 6974
use or disclose the protected health information for any purpose 6975
other than the litigation or proceeding for which the information 6976
was requested and shall return the protected health information to 6977
the covered entity or destroy the protected health information, 6978
including all copies made, at the conclusion of the litigation or 6979
proceeding.6980

       (2)(a) If any law enforcement officer submits a written6981
statement to a health care provider that states that an official6982
criminal investigation has begun regarding a specified person or6983
that a criminal action or proceeding has been commenced against a6984
specified person, that requests the provider to supply to the6985
officer copies of any records the provider possesses that pertain6986
to any test or the results of any test administered to the6987
specified person to determine the presence or concentration of6988
alcohol, a drug of abuse, a combination of them, a controlled 6989
substance, or a metabolite of a controlled substance in the 6990
person's whole blood, blood serum or plasma, breath, or urine at 6991
any time relevant to the criminal offense in question, and that 6992
conforms to section 2317.022 of the Revised Code, the provider, 6993
except to the extent specifically prohibited by any law of this 6994
state or of the United States, shall supply to the officer a copy 6995
of any of the requested records the provider possesses. If the 6996
health care provider does not possess any of the requested 6997
records, the provider shall give the officer a written statement 6998
that indicates that the provider does not possess any of the 6999
requested records.7000

       (b) If a health care provider possesses any records of the7001
type described in division (B)(2)(a) of this section regarding the7002
person in question at any time relevant to the criminal offense in7003
question, in lieu of personally testifying as to the results of7004
the test in question, the custodian of the records may submit a7005
certified copy of the records, and, upon its submission, the7006
certified copy is qualified as authentic evidence and may be7007
admitted as evidence in accordance with the Rules of Evidence.7008
Division (A) of section 2317.422 of the Revised Code does not7009
apply to any certified copy of records submitted in accordance7010
with this division. Nothing in this division shall be construed to 7011
limit the right of any party to call as a witness the person who7012
administered the test to which the records pertain, the person7013
under whose supervision the test was administered, the custodian7014
of the records, the person who made the records, or the person7015
under whose supervision the records were made.7016

       (3)(a) If the testimonial privilege described in division7017
(B)(1) of this section does not apply as provided in division7018
(B)(1)(a)(iii) of this section, a physician or dentist may be7019
compelled to testify or to submit to discovery under the Rules of7020
Civil Procedure only as to a communication made to the physician7021
or dentist by the patient in question in that relation, or the7022
physician's or dentist's advice to the patient in question, that7023
related causally or historically to physical or mental injuries7024
that are relevant to issues in the medical claim, dental claim,7025
chiropractic claim, or optometric claim, action for wrongful7026
death, other civil action, or claim under Chapter 4123. of the7027
Revised Code.7028

       (b) If the testimonial privilege described in division (B)(1) 7029
of this section does not apply to a physician or dentist as7030
provided in division (B)(1)(c) of this section, the physician or7031
dentist, in lieu of personally testifying as to the results of the7032
test in question, may submit a certified copy of those results,7033
and, upon its submission, the certified copy is qualified as7034
authentic evidence and may be admitted as evidence in accordance7035
with the Rules of Evidence. Division (A) of section 2317.422 of7036
the Revised Code does not apply to any certified copy of results7037
submitted in accordance with this division. Nothing in this7038
division shall be construed to limit the right of any party to7039
call as a witness the person who administered the test in7040
question, the person under whose supervision the test was7041
administered, the custodian of the results of the test, the person7042
who compiled the results, or the person under whose supervision7043
the results were compiled.7044

       (4) The testimonial privilege described in division (B)(1) of 7045
this section is not waived when a communication is made by a7046
physician to a pharmacist or when there is communication between a7047
patient and a pharmacist in furtherance of the physician-patient7048
relation.7049

       (5)(a) As used in divisions (B)(1) to (4) of this section,7050
"communication" means acquiring, recording, or transmitting any7051
information, in any manner, concerning any facts, opinions, or7052
statements necessary to enable a physician or dentist to diagnose,7053
treat, prescribe, or act for a patient. A "communication" may7054
include, but is not limited to, any medical or dental, office, or7055
hospital communication such as a record, chart, letter,7056
memorandum, laboratory test and results, x-ray, photograph,7057
financial statement, diagnosis, or prognosis.7058

       (b) As used in division (B)(2) of this section, "health care7059
provider" means a hospital, ambulatory care facility, long-term7060
care facility, pharmacy, emergency facility, or health care7061
practitioner.7062

       (c) As used in division (B)(5)(b) of this section:7063

       (i) "Ambulatory care facility" means a facility that provides7064
medical, diagnostic, or surgical treatment to patients who do not7065
require hospitalization, including a dialysis center, ambulatory7066
surgical facility, cardiac catheterization facility, diagnostic7067
imaging center, extracorporeal shock wave lithotripsy center, home7068
health agency, inpatient hospice, birthing center, radiation7069
therapy center, emergency facility, and an urgent care center.7070
"Ambulatory health care facility" does not include the private7071
office of a physician or dentist, whether the office is for an7072
individual or group practice.7073

       (ii) "Emergency facility" means a hospital emergency7074
department or any other facility that provides emergency medical7075
services.7076

       (iii) "Health care practitioner" has the same meaning as in7077
section 4769.01 of the Revised Code.7078

       (iv) "Hospital" has the same meaning as in section 3727.01 of7079
the Revised Code.7080

       (v) "Long-term care facility" means a nursing home,7081
residential care facility, or home for the aging, as those terms7082
are defined in section 3721.01 of the Revised Code; an adult care7083
facility, as defined in section 3722.01 of the Revised Code; a7084
nursing facility or intermediate care facility for the mentally7085
retarded, as those terms are defined in section 5111.205164.01 of 7086
the Revised Code; a facility or portion of a facility certified as 7087
a skilled nursing facility under Title XVIII of the "Social7088
Security Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended.7089

       (vi) "Pharmacy" has the same meaning as in section 4729.01 of7090
the Revised Code.7091

       (d) As used in divisions (B)(1) and (2) of this section, 7092
"drug of abuse" has the same meaning as in section 4506.01 of the 7093
Revised Code.7094

       (6) Divisions (B)(1), (2), (3), (4), and (5) of this section7095
apply to doctors of medicine, doctors of osteopathic medicine,7096
doctors of podiatry, and dentists.7097

       (7) Nothing in divisions (B)(1) to (6) of this section7098
affects, or shall be construed as affecting, the immunity from7099
civil liability conferred by section 307.628 of the Revised Code 7100
or the immunity from civil liability conferred by section 2305.33 7101
of the Revised Code upon physicians who report an employee's use 7102
of a drug of abuse, or a condition of an employee other than one7103
involving the use of a drug of abuse, to the employer of the7104
employee in accordance with division (B) of that section. As used7105
in division (B)(7) of this section, "employee," "employer," and7106
"physician" have the same meanings as in section 2305.33 of the7107
Revised Code.7108

       (C)(1) A cleric, when the cleric remains accountable to the 7109
authority of that cleric's church, denomination, or sect, 7110
concerning a confession made, or any information confidentially 7111
communicated, to the cleric for a religious counseling purpose in 7112
the cleric's professional character. The cleric may testify by7113
express consent of the person making the communication, except7114
when the disclosure of the information is in violation of a sacred7115
trust and except that, if the person voluntarily testifies or is 7116
deemed by division (A)(4)(c) of section 2151.421 of the Revised 7117
Code to have waived any testimonial privilege under this division, 7118
the cleric may be compelled to testify on the same subject except 7119
when disclosure of the information is in violation of a sacred 7120
trust.7121

       (2) As used in division (C) of this section:7122

        (a) "Cleric" means a member of the clergy, rabbi, priest, 7123
Christian Science practitioner, or regularly ordained, accredited, 7124
or licensed minister of an established and legally cognizable 7125
church, denomination, or sect.7126

        (b) "Sacred trust" means a confession or confidential 7127
communication made to a cleric in the cleric's ecclesiastical 7128
capacity in the course of discipline enjoined by the church to 7129
which the cleric belongs, including, but not limited to, the 7130
Catholic Church, if both of the following apply:7131

        (i) The confession or confidential communication was made 7132
directly to the cleric.7133

        (ii) The confession or confidential communication was made in 7134
the manner and context that places the cleric specifically and 7135
strictly under a level of confidentiality that is considered 7136
inviolate by canon law or church doctrine.7137

       (D) Husband or wife, concerning any communication made by one 7138
to the other, or an act done by either in the presence of the7139
other, during coverture, unless the communication was made, or act7140
done, in the known presence or hearing of a third person competent7141
to be a witness; and such rule is the same if the marital relation7142
has ceased to exist;7143

       (E) A person who assigns a claim or interest, concerning any7144
matter in respect to which the person would not, if a party, be7145
permitted to testify;7146

       (F) A person who, if a party, would be restricted under7147
section 2317.03 of the Revised Code, when the property or thing is7148
sold or transferred by an executor, administrator, guardian,7149
trustee, heir, devisee, or legatee, shall be restricted in the7150
same manner in any action or proceeding concerning the property or7151
thing.7152

       (G)(1) A school guidance counselor who holds a valid educator 7153
license from the state board of education as provided for in 7154
section 3319.22 of the Revised Code, a person licensed under7155
Chapter 4757. of the Revised Code as a professional clinical7156
counselor, professional counselor, social worker, independent7157
social worker, marriage and family therapist or independent 7158
marriage and family therapist, or registered under Chapter 4757. 7159
of the Revised Code as a social work assistant concerning a 7160
confidential communication received from a client in that relation 7161
or the person's advice to a client unless any of the following 7162
applies:7163

       (a) The communication or advice indicates clear and present7164
danger to the client or other persons. For the purposes of this7165
division, cases in which there are indications of present or past7166
child abuse or neglect of the client constitute a clear and7167
present danger.7168

       (b) The client gives express consent to the testimony.7169

       (c) If the client is deceased, the surviving spouse or the7170
executor or administrator of the estate of the deceased client7171
gives express consent.7172

       (d) The client voluntarily testifies, in which case the7173
school guidance counselor or person licensed or registered under7174
Chapter 4757. of the Revised Code may be compelled to testify on7175
the same subject.7176

       (e) The court in camera determines that the information7177
communicated by the client is not germane to the counselor-client, 7178
marriage and family therapist-client, or social worker-client 7179
relationship.7180

       (f) A court, in an action brought against a school, its7181
administration, or any of its personnel by the client, rules after7182
an in-camera inspection that the testimony of the school guidance7183
counselor is relevant to that action.7184

       (g) The testimony is sought in a civil action and concerns7185
court-ordered treatment or services received by a patient as part7186
of a case plan journalized under section 2151.412 of the Revised7187
Code or the court-ordered treatment or services are necessary or7188
relevant to dependency, neglect, or abuse or temporary or7189
permanent custody proceedings under Chapter 2151. of the Revised7190
Code.7191

       (2) Nothing in division (G)(1) of this section shall relieve7192
a school guidance counselor or a person licensed or registered7193
under Chapter 4757. of the Revised Code from the requirement to7194
report information concerning child abuse or neglect under section7195
2151.421 of the Revised Code.7196

       (H) A mediator acting under a mediation order issued under7197
division (A) of section 3109.052 of the Revised Code or otherwise7198
issued in any proceeding for divorce, dissolution, legal7199
separation, annulment, or the allocation of parental rights and7200
responsibilities for the care of children, in any action or7201
proceeding, other than a criminal, delinquency, child abuse, child7202
neglect, or dependent child action or proceeding, that is brought7203
by or against either parent who takes part in mediation in7204
accordance with the order and that pertains to the mediation7205
process, to any information discussed or presented in the7206
mediation process, to the allocation of parental rights and7207
responsibilities for the care of the parents' children, or to the7208
awarding of parenting time rights in relation to their children;7209

       (I) A communications assistant, acting within the scope of7210
the communication assistant's authority, when providing7211
telecommunications relay service pursuant to section 4931.35 of7212
the Revised Code or Title II of the "Communications Act of 1934,"7213
104 Stat. 366 (1990), 47 U.S.C. 225, concerning a communication7214
made through a telecommunications relay service. Nothing in this7215
section shall limit the obligation of a communications assistant7216
to divulge information or testify when mandated by federal law or7217
regulation or pursuant to subpoena in a criminal proceeding.7218

       Nothing in this section shall limit any immunity or privilege7219
granted under federal law or regulation.7220

       (J)(1) A chiropractor in a civil proceeding concerning a7221
communication made to the chiropractor by a patient in that7222
relation or the chiropractor's advice to a patient, except as7223
otherwise provided in this division. The testimonial privilege7224
established under this division does not apply, and a chiropractor7225
may testify or may be compelled to testify, in any civil action,7226
in accordance with the discovery provisions of the Rules of Civil7227
Procedure in connection with a civil action, or in connection with7228
a claim under Chapter 4123. of the Revised Code, under any of the7229
following circumstances:7230

       (a) If the patient or the guardian or other legal7231
representative of the patient gives express consent.7232

       (b) If the patient is deceased, the spouse of the patient or7233
the executor or administrator of the patient's estate gives7234
express consent.7235

       (c) If a medical claim, dental claim, chiropractic claim, or7236
optometric claim, as defined in section 2305.113 of the Revised7237
Code, an action for wrongful death, any other type of civil7238
action, or a claim under Chapter 4123. of the Revised Code is7239
filed by the patient, the personal representative of the estate of7240
the patient if deceased, or the patient's guardian or other legal7241
representative.7242

       (2) If the testimonial privilege described in division (J)(1) 7243
of this section does not apply as provided in division (J)(1)(c) 7244
of this section, a chiropractor may be compelled to testify or to 7245
submit to discovery under the Rules of Civil Procedure only as to 7246
a communication made to the chiropractor by the patient in 7247
question in that relation, or the chiropractor's advice to the7248
patient in question, that related causally or historically to7249
physical or mental injuries that are relevant to issues in the7250
medical claim, dental claim, chiropractic claim, or optometric7251
claim, action for wrongful death, other civil action, or claim7252
under Chapter 4123. of the Revised Code.7253

       (3) The testimonial privilege established under this division 7254
does not apply, and a chiropractor may testify or be compelled to 7255
testify, in any criminal action or administrative proceeding.7256

       (4) As used in this division, "communication" means7257
acquiring, recording, or transmitting any information, in any7258
manner, concerning any facts, opinions, or statements necessary to7259
enable a chiropractor to diagnose, treat, or act for a patient. A7260
communication may include, but is not limited to, any7261
chiropractic, office, or hospital communication such as a record,7262
chart, letter, memorandum, laboratory test and results, x-ray,7263
photograph, financial statement, diagnosis, or prognosis.7264

       (K)(1) Except as provided under division (K)(2) of this 7265
section, a critical incident stress management team member 7266
concerning a communication received from an individual who 7267
receives crisis response services from the team member, or the 7268
team member's advice to the individual, during a debriefing 7269
session.7270

        (2) The testimonial privilege established under division 7271
(K)(1) of this section does not apply if any of the following are 7272
true:7273

        (a) The communication or advice indicates clear and present 7274
danger to the individual who receives crisis response services or 7275
to other persons. For purposes of this division, cases in which 7276
there are indications of present or past child abuse or neglect of 7277
the individual constitute a clear and present danger.7278

        (b) The individual who received crisis response services 7279
gives express consent to the testimony.7280

       (c) If the individual who received crisis response services 7281
is deceased, the surviving spouse or the executor or administrator 7282
of the estate of the deceased individual gives express consent.7283

        (d) The individual who received crisis response services 7284
voluntarily testifies, in which case the team member may be 7285
compelled to testify on the same subject.7286

        (e) The court in camera determines that the information 7287
communicated by the individual who received crisis response 7288
services is not germane to the relationship between the individual 7289
and the team member.7290

       (f) The communication or advice pertains or is related to any 7291
criminal act.7292

       (3) As used in division (K) of this section:7293

       (a) "Crisis response services" means consultation, risk 7294
assessment, referral, and on-site crisis intervention services 7295
provided by a critical incident stress management team to 7296
individuals affected by crisis or disaster.7297

       (b) "Critical incident stress management team member" or 7298
"team member" means an individual specially trained to provide 7299
crisis response services as a member of an organized community or 7300
local crisis response team that holds membership in the Ohio 7301
critical incident stress management network.7302

       (c) "Debriefing session" means a session at which crisis 7303
response services are rendered by a critical incident stress 7304
management team member during or after a crisis or disaster.7305

       (L)(1) Subject to division (L)(2) of this section and except7306
as provided in division (L)(3) of this section, an employee7307
assistance professional, concerning a communication made to the7308
employee assistance professional by a client in the employee7309
assistance professional's official capacity as an employee7310
assistance professional.7311

        (2) Division (L)(1) of this section applies to an employee7312
assistance professional who meets either or both of the following7313
requirements:7314

        (a) Is certified by the employee assistance certification7315
commission to engage in the employee assistance profession;7316

        (b) Has education, training, and experience in all of the7317
following:7318

        (i) Providing workplace-based services designed to address7319
employer and employee productivity issues;7320

        (ii) Providing assistance to employees and employees'7321
dependents in identifying and finding the means to resolve7322
personal problems that affect the employees or the employees'7323
performance;7324

       (iii) Identifying and resolving productivity problems7325
associated with an employee's concerns about any of the following7326
matters: health, marriage, family, finances, substance abuse or7327
other addiction, workplace, law, and emotional issues;7328

       (iv) Selecting and evaluating available community resources;7329

        (v) Making appropriate referrals;7330

        (vi) Local and national employee assistance agreements;7331

        (vii) Client confidentiality.7332

        (3) Division (L)(1) of this section does not apply to any of 7333
the following:7334

        (a) A criminal action or proceeding involving an offense7335
under sections 2903.01 to 2903.06 of the Revised Code if the7336
employee assistance professional's disclosure or testimony relates7337
directly to the facts or immediate circumstances of the offense;7338

        (b) A communication made by a client to an employee7339
assistance professional that reveals the contemplation or7340
commission of a crime or serious, harmful act;7341

        (c) A communication that is made by a client who is an7342
unemancipated minor or an adult adjudicated to be incompetent and7343
indicates that the client was the victim of a crime or abuse;7344

       (d) A civil proceeding to determine an individual's mental7345
competency or a criminal action in which a plea of not guilty by7346
reason of insanity is entered;7347

        (e) A civil or criminal malpractice action brought against7348
the employee assistance professional;7349

        (f) When the employee assistance professional has the express 7350
consent of the client or, if the client is deceased or disabled, 7351
the client's legal representative;7352

        (g) When the testimonial privilege otherwise provided by7353
division (L)(1) of this section is abrogated under law.7354

       Sec. 2335.39.  (A) As used in this section:7355

       (1) "Court" means any court of record.7356

       (2) "Eligible party" means a party to an action or appeal7357
involving the state, other than the following:7358

       (a) The state;7359

       (b) An individual whose net worth exceeded one million7360
dollars at the time the action or appeal was filed;7361

       (c) A sole owner of an unincorporated business that had, or a 7362
partnership, corporation, association, or organization that had, a 7363
net worth exceeding five million dollars at the time the action or 7364
appeal was filed, except that an organization that is described in 7365
subsection 501(c)(3) and is tax exempt under subsection 501(a) of 7366
the Internal Revenue Code shall not be excluded as an eligible 7367
party under this division because of its net worth;7368

       (d) A sole owner of an unincorporated business that employed, 7369
or a partnership, corporation, association, or organization that 7370
employed, more than five hundred persons at the time the action or 7371
appeal was filed.7372

       (3) "Fees" means reasonable attorney's fees, in an amount not 7373
to exceed seventy-five dollars per hour or a higher hourly fee 7374
approved by the court.7375

       (4) "Internal Revenue Code" means the "Internal Revenue Code 7376
of 1954," 68A Stat. 3, 26 U.S.C. 1, as amended.7377

       (5) "Prevailing eligible party" means an eligible party that 7378
prevails in an action or appeal involving the state.7379

       (6) "State" has the same meaning as in section 2743.01 of the 7380
Revised Code.7381

       (B)(1) Except as provided in divisions (B)(2) and (F) of this 7382
section, in a civil action, or appeal of a judgment in a civil 7383
action, to which the state is a party, or in an appeal of an 7384
adjudication order of an agency pursuant to section 119.12 of the 7385
Revised Code, the prevailing eligible party is entitled, upon7386
filing a motion in accordance with this division, to compensation7387
for fees incurred by that party in connection with the action or7388
appeal. Compensation, when payable to a prevailing eligible party 7389
under this section, is in addition to any other costs and expenses 7390
that may be awarded to that party by the court pursuant to law or 7391
rule.7392

       A prevailing eligible party that desires an award of7393
compensation for fees shall file a motion requesting the award7394
with the court within thirty days after the court enters final7395
judgment in the action or appeal. The motion shall do all of the7396
following:7397

       (a) Identify the party;7398

       (b) Indicate that the party is the prevailing eligible party 7399
and is entitled to receive an award of compensation for fees;7400

       (c) Include a statement that the state's position in7401
initiating the matter in controversy was not substantially7402
justified;7403

       (d) Indicate the amount sought as an award;7404

       (e) Itemize all fees sought in the requested award. The7405
itemization shall include a statement from any attorney who7406
represented the prevailing eligible party, that indicates the fees 7407
charged, the actual time expended, and the rate at which the fees 7408
were calculated.7409

       (2) Upon the filing of a motion under this section, the court 7410
shall review the request for the award of compensation for fees 7411
and determine whether the position of the state in initiating the 7412
matter in controversy was substantially justified, whether special 7413
circumstances make an award unjust, and whether the prevailing 7414
eligible party engaged in conduct during the course of the action 7415
or appeal that unduly and unreasonably protracted the final 7416
resolution of the matter in controversy. The court shall issue an 7417
order, in writing, on the motion of the prevailing eligible party, 7418
which order shall include a statement indicating whether an award 7419
has been granted, the findings and conclusions underlying it, the 7420
reasons or bases for the findings and conclusions, and, if an 7421
award has been granted, its amount. The order shall be included in 7422
the record of the action or appeal, and the clerk of the court 7423
shall mail a certified copy of it to the state and the prevailing 7424
eligible party.7425

       With respect to a motion under this section, the state has7426
the burden of proving that its position in initiating the matter7427
in controversy was substantially justified, that special7428
circumstances make an award unjust, or that the prevailing7429
eligible party engaged in conduct during the course of the action7430
or appeal that unduly and unreasonably protracted the final7431
resolution of the matter in controversy.7432

       A court considering a motion under this section may deny an7433
award entirely, or reduce the amount of an award that otherwise7434
would be payable, to a prevailing eligible party only as follows:7435

       (a) If the court determines that the state has sustained its 7436
burden of proof that its position in initiating the matter in7437
controversy was substantially justified or that special7438
circumstances make an award unjust, the motion shall be denied;7439

       (b) If the court determines that the state has sustained its 7440
burden of proof that the prevailing eligible party engaged in7441
conduct during the course of the action or appeal that unduly and7442
unreasonably protracted the final resolution of the matter in7443
controversy, the court may reduce the amount of an award, or deny7444
an award, to that party to the extent of that conduct.7445

       An order of a court considering a motion under this section7446
is appealable as in other cases, by a prevailing eligible party7447
that is denied an award or receives a reduced award. If the case7448
is an appeal of the adjudication order of an agency pursuant to7449
section 119.12 of the Revised Code, the agency may appeal an order 7450
granting an award. The order of the court may be modified by the 7451
appellate court only if it finds that the grant or the failure to 7452
grant an award, or the calculation of the amount of an award, 7453
involved an abuse of discretion.7454

       (C) Compensation for fees awarded to a prevailing eligible7455
party under this section may be paid by the specific branch of the 7456
state government or the state department, board, office,7457
commission, agency, institution, or other instrumentality over7458
which the party prevailed in the action or appeal from any funds7459
available to it for payment of such compensation. If compensation 7460
is not paid from such funds or such funds are not available, upon 7461
the filing of the court's order in favor of the prevailing 7462
eligible party with the clerk of the court of claims, the order 7463
shall be treated as if it were a judgment under Chapter 2743. of 7464
the Revised Code and be payable in accordance with the procedures 7465
specified in section 2743.19 of the Revised Code, except that 7466
interest shall not be paid in relation to the award.7467

       (D) If compensation for fees is awarded under this section to 7468
a prevailing eligible party that is appealing an agency7469
adjudication order pursuant to section 119.12 of the Revised Code, 7470
it shall include the fees incurred in the appeal and, if requested 7471
in the motion, the fees incurred by the party in the adjudication 7472
hearing conducted under Chapter 119. of the Revised Code. A motion 7473
containing such a request shall itemize, in the manner described 7474
in division (B)(1)(e) of section 119.092 of the Revised Code, the 7475
fees, as defined in that section, that are sought in an award.7476

       (E) Each court that orders during any fiscal year7477
compensation for fees to be paid to a prevailing eligible party7478
pursuant to this section shall prepare a report for that year. The 7479
report shall be completed no later than the first day of October 7480
of the fiscal year following the fiscal year covered by the 7481
report, and copies of it shall be filed with the general assembly. 7482
It shall contain the following information:7483

       (1) The total amount and total number of awards of7484
compensation for fees required to be paid to prevailing eligible7485
parties;7486

       (2) The amount and nature of each individual award ordered;7487

       (3) Any other information that may aid the general assembly 7488
in evaluating the scope and impact of awards of compensation for 7489
fees.7490

       (F) The provisions of this section do not apply in any of the 7491
following:7492

       (1) Appropriation proceedings under Chapter 163. of the 7493
Revised Code;7494

       (2) Civil actions or appeals of civil actions that involve 7495
torts;7496

       (3) An appeal pursuant to section 119.12 of the Revised Code7497
that involves any of the following:7498

       (a) An adjudication order entered after a hearing described 7499
in division (F) of section 119.092 of the Revised Code;7500

       (b) A prevailing eligible party represented in the appeal by 7501
an attorney who was paid pursuant to an appropriation by the 7502
federal or state government or a local government;7503

       (c) An administrative appeal decision made under section 7504
5101.35 or 5160.34 of the Revised Code.7505

       Sec. 2505.02.  (A) As used in this section:7506

       (1) "Substantial right" means a right that the United States 7507
Constitution, the Ohio Constitution, a statute, the common law, or 7508
a rule of procedure entitles a person to enforce or protect.7509

       (2) "Special proceeding" means an action or proceeding that 7510
is specially created by statute and that prior to 1853 was not 7511
denoted as an action at law or a suit in equity.7512

       (3) "Provisional remedy" means a proceeding ancillary to an 7513
action, including, but not limited to, a proceeding for a 7514
preliminary injunction, attachment, discovery of privileged 7515
matter, suppression of evidence, a prima-facie showing pursuant 7516
to section 2307.85 or 2307.86 of the Revised Code, a prima-facie 7517
showing pursuant to section 2307.92 of the Revised Code, or a 7518
finding made pursuant to division (A)(3) of section 2307.93 of the 7519
Revised Code.7520

       (B) An order is a final order that may be reviewed, affirmed,7521
modified, or reversed, with or without retrial, when it is one of 7522
the following:7523

       (1) An order that affects a substantial right in an action7524
that in effect determines the action and prevents a judgment;7525

       (2) An order that affects a substantial right made in a 7526
special proceeding or upon a summary application in an action 7527
after judgment;7528

       (3) An order that vacates or sets aside a judgment or grants 7529
a new trial;7530

       (4) An order that grants or denies a provisional remedy and 7531
to which both of the following apply:7532

       (a) The order in effect determines the action with respect to 7533
the provisional remedy and prevents a judgment in the action in 7534
favor of the appealing party with respect to the provisional 7535
remedy.7536

       (b) The appealing party would not be afforded a meaningful or7537
effective remedy by an appeal following final judgment as to all 7538
proceedings, issues, claims, and parties in the action.7539

       (5) An order that determines that an action may or may not be7540
maintained as a class action;7541

       (6) An order determining the constitutionality of any changes 7542
to the Revised Code made by Am. Sub. S.B. 281 of the 124th general 7543
assembly, including the amendment of sections 1751.67, 2117.06, 7544
2305.11, 2305.15, 2305.234, 2317.02, 2317.54, 2323.56, 2711.21, 7545
2711.22, 2711.23, 2711.24, 2743.02, 2743.43, 2919.16, 3923.63, 7546
3923.64, 4705.15, and 5111.0185163.17, and the enactment of 7547
sections 2305.113, 2323.41, 2323.43, and 2323.55 of the Revised 7548
Code or any changes made by Sub. S.B. 80 of the 125th general 7549
assembly, including the amendment of sections 2125.02, 2305.10, 7550
2305.131, 2315.18, 2315.19, and 2315.21 of the Revised Code;7551

       (7) An order in an appropriation proceeding that may be 7552
appealed pursuant to division (B)(3) of section 163.09 of the 7553
Revised Code.7554

       (C) When a court issues an order that vacates or sets aside a7555
judgment or grants a new trial, the court, upon the request of 7556
either party, shall state in the order the grounds upon which the 7557
new trial is granted or the judgment vacated or set aside.7558

       (D) This section applies to and governs any action, including 7559
an appeal, that is pending in any court on July 22, 1998, and all 7560
claims filed or actions commenced on or after July 22, 1998, 7561
notwithstanding any provision of any prior statute or rule of law 7562
of this state.7563

       Sec. 2705.02.  A person guilty of any of the following acts7564
may be punished as for a contempt:7565

       (A) Disobedience of, or resistance to, a lawful writ,7566
process, order, rule, judgment, or command of a court or officer;7567

       (B) Misbehavior of an officer of the court in the performance 7568
of official duties, or in official transactions;7569

       (C) A failure to obey a subpoena duly served, or a refusal to 7570
be sworn or to answer as a witness, when lawfully required;7571

       (D) The rescue, or attempted rescue, of a person or of7572
property in the custody of an officer by virtue of an order or7573
process of court held by the officer;7574

       (E) A failure upon the part of a person recognized to appear7575
as a witness in a court to appear in compliance with the terms of7576
the person's recognizance;7577

       (F) A failure to comply with an order issued pursuant to7578
section 3109.19 or 3111.81 of the Revised Code;7579

       (G) A failure to obey a subpoena issued by the department of7580
job and family services or a child support enforcement agency7581
pursuant to section 5101.37 of the Revised Code;7582

       (H) A failure to obey a subpoena issued by the department of 7583
health care administration pursuant to section 5160.28 of the 7584
Revised Code;7585

       (I) A willful failure to submit to genetic testing, or a7586
willful failure to submit a child to genetic testing, as required7587
by an order for genetic testing issued under section 3111.41 of7588
the Revised Code.7589

       Sec. 2744.05.  Notwithstanding any other provisions of the7590
Revised Code or rules of a court to the contrary, in an action7591
against a political subdivision to recover damages for injury,7592
death, or loss to person or property caused by an act or omission7593
in connection with a governmental or proprietary function:7594

       (A) Punitive or exemplary damages shall not be awarded.7595

       (B)(1) If a claimant receives or is entitled to receive7596
benefits for injuries or loss allegedly incurred from a policy or7597
policies of insurance or any other source, the benefits shall be7598
disclosed to the court, and the amount of the benefits shall be7599
deducted from any award against a political subdivision recovered7600
by that claimant. No insurer or other person is entitled to bring7601
an action under a subrogation provision in an insurance or other7602
contract against a political subdivision with respect to those7603
benefits.7604

       The amount of the benefits shall be deducted from an award7605
against a political subdivision under division (B)(1) of this7606
section regardless of whether the claimant may be under an7607
obligation to pay back the benefits upon recovery, in whole or in7608
part, for the claim. A claimant whose benefits have been deducted7609
from an award under division (B)(1) of this section is not7610
considered fully compensated and shall not be required to7611
reimburse a subrogated claim for benefits deducted from an award7612
pursuant to division (B)(1) of this section.7613

       (2) Nothing in division (B)(1) of this section shall be7614
construed to do either of the following:7615

       (a) Limit the rights of a beneficiary under a life insurance7616
policy or the rights of sureties under fidelity or surety bonds;7617

       (b) Prohibit the department of job and family serviceshealth 7618
care administration from recovering from the political 7619
subdivision, pursuant to section 5101.585160.38 of the Revised7620
Code, the cost of medical assistance benefits provided under 7621
sections 5101.5211 to 5101.5216 or Chapter 5107., 5111., or 5115.7622
of the Revised Codethe medicaid program, disability medical 7623
assistance program, or children's buy-in program.7624

       (C)(1) There shall not be any limitation on compensatory7625
damages that represent the actual loss of the person who is7626
awarded the damages. However, except in wrongful death actions7627
brought pursuant to Chapter 2125. of the Revised Code, damages7628
that arise from the same cause of action, transaction or7629
occurrence, or series of transactions or occurrences and that do7630
not represent the actual loss of the person who is awarded the7631
damages shall not exceed two hundred fifty thousand dollars in7632
favor of any one person. The limitation on damages that do not7633
represent the actual loss of the person who is awarded the damages7634
provided in this division does not apply to court costs that are7635
awarded to a plaintiff, or to interest on a judgment rendered in7636
favor of a plaintiff, in an action against a political7637
subdivision.7638

       (2) As used in this division, "the actual loss of the person7639
who is awarded the damages" includes all of the following:7640

       (a) All wages, salaries, or other compensation lost by the7641
person injured as a result of the injury, including wages,7642
salaries, or other compensation lost as of the date of a judgment7643
and future expected lost earnings of the person injured;7644

       (b) All expenditures of the person injured or another person7645
on behalf of the person injured for medical care or treatment, for7646
rehabilitation services, or for other care, treatment, services,7647
products, or accommodations that were necessary because of the7648
injury;7649

       (c) All expenditures to be incurred in the future, as7650
determined by the court, by the person injured or another person7651
on behalf of the person injured for medical care or treatment, for7652
rehabilitation services, or for other care, treatment, services,7653
products, or accommodations that will be necessary because of the7654
injury;7655

       (d) All expenditures of a person whose property was injured7656
or destroyed or of another person on behalf of the person whose7657
property was injured or destroyed in order to repair or replace7658
the property that was injured or destroyed;7659

       (e) All expenditures of the person injured or of the person7660
whose property was injured or destroyed or of another person on7661
behalf of the person injured or of the person whose property was7662
injured or destroyed in relation to the actual preparation or7663
presentation of the claim involved;7664

       (f) Any other expenditures of the person injured or of the7665
person whose property was injured or destroyed or of another7666
person on behalf of the person injured or of the person whose7667
property was injured or destroyed that the court determines7668
represent an actual loss experienced because of the personal or7669
property injury or property loss.7670

       "The actual loss of the person who is awarded the damages"7671
does not include any fees paid or owed to an attorney for any7672
services rendered in relation to a personal or property injury or7673
property loss, and does not include any damages awarded for pain7674
and suffering, for the loss of society, consortium, companionship,7675
care, assistance, attention, protection, advice, guidance,7676
counsel, instruction, training, or education of the person7677
injured, for mental anguish, or for any other intangible loss.7678

       Sec. 2903.33.  As used in sections 2903.33 to 2903.36 of the 7679
Revised Code:7680

       (A) "Care facility" means any of the following:7681

       (1) Any "home" as defined in section 3721.10 or 5111.207682
5164.01 of the Revised Code;7683

       (2) Any "residential facility" as defined in section 5123.19 7684
of the Revised Code;7685

       (3) Any institution or facility operated or provided by the 7686
department of mental health or by the department of mental7687
retardation and developmental disabilities pursuant to sections7688
5119.02 and 5123.03 of the Revised Code;7689

       (4) Any "residential facility" as defined in section 5119.22 7690
of the Revised Code;7691

       (5) Any unit of any hospital, as defined in section 3701.01 7692
of the Revised Code, that provides the same services as a nursing 7693
home, as defined in section 3721.01 of the Revised Code;7694

       (6) Any institution, residence, or facility that provides,7695
for a period of more than twenty-four hours, whether for a7696
consideration or not, accommodations to one individual or two7697
unrelated individuals who are dependent upon the services of7698
others;7699

       (7) Any "adult care facility" as defined in section 3722.01 7700
of the Revised Code;7701

       (8) Any adult foster home certified by the department of7702
aging or its designee under section 173.36 of the Revised Code;7703

       (9) Any "community alternative home" as defined in section7704
3724.01 of the Revised Code.7705

       (B) "Abuse" means knowingly causing physical harm or7706
recklessly causing serious physical harm to a person by physical7707
contact with the person or by the inappropriate use of a physical7708
or chemical restraint, medication, or isolation on the person.7709

       (C)(1) "Gross neglect" means knowingly failing to provide a 7710
person with any treatment, care, goods, or service that is7711
necessary to maintain the health or safety of the person when the7712
failure results in physical harm or serious physical harm to the7713
person.7714

       (2) "Neglect" means recklessly failing to provide a person7715
with any treatment, care, goods, or service that is necessary to7716
maintain the health or safety of the person when the failure7717
results in serious physical harm to the person.7718

       (D) "Inappropriate use of a physical or chemical restraint, 7719
medication, or isolation" means the use of physical or chemical 7720
restraint, medication, or isolation as punishment, for staff 7721
convenience, excessively, as a substitute for treatment, or in 7722
quantities that preclude habilitation and treatment.7723

       Sec. 2913.40.  (A) As used in this section:7724

       (1) "Statement or representation" means any oral, written,7725
electronic, electronic impulse, or magnetic communication that is7726
used to identify an item of goods or a service for which7727
reimbursement may be made under the medical assistancemedicaid7728
program or that states income and expense and is or may be used to 7729
determine a rate of reimbursement under the medical assistance7730
medicaid program.7731

       (2) "Medical assistance program" means the program7732
established by the department of job and family services to7733
provide medical assistance under section 5111.01 of the Revised7734
Code and the medicaid program of Title XIX of the "Social Security7735
Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended.7736

       (3) "Provider" means any person who has signed a provider7737
agreement with the department of job and family serviceshealth 7738
care administration to provide goods or services pursuant to the 7739
medical assistancemedicaid program or any person who has signed 7740
an agreement with a party to such a provider agreement under which 7741
the person agrees to provide goods or services that are 7742
reimbursable under the medical assistancemedicaid program.7743

       (4) "Provider agreement" means an oral or written agreement7744
between the department of job and family serviceshealth care 7745
administration and a person in which the person agrees to provide 7746
goods or services under the medical assistancemedicaid program.7747

       (5) "Recipient" means any individual who receives goods or7748
services from a provider under the medical assistancemedicaid7749
program.7750

       (6) "Records" means any medical, professional, financial, or7751
business records relating to the treatment or care of any7752
recipient, to goods or services provided to any recipient, or to7753
rates paid for goods or services provided to any recipient and any7754
records that are required by the rules of the director of job and7755
family serviceshealth care administration to be kept for the 7756
medical assistancemedicaid program.7757

       (B) No person shall knowingly make or cause to be made a7758
false or misleading statement or representation for use in7759
obtaining reimbursement from the medical assistancemedicaid7760
program.7761

       (C) No person, with purpose to commit fraud or knowing that7762
the person is facilitating a fraud, shall do either of the7763
following:7764

       (1) Contrary to the terms of the person's provider agreement,7765
charge, solicit, accept, or receive for goods or services that the7766
person provides under the medical assistancemedicaid program any 7767
property, money, or other consideration in addition to the amount 7768
of reimbursement under the medical assistancemedicaid program and 7769
the person's provider agreement for the goods or services and any 7770
cost-sharing expenses authorized by section 5111.01125162.35 of7771
the Revised Code or rules adopted pursuant to section 5111.01, 7772
5111.011,5162.20 or 5111.025163.15 of the Revised Code.7773

       (2) Solicit, offer, or receive any remuneration, other than7774
any cost-sharing expenses authorized by section 5111.01125162.357775
of the Revised Code or rules adopted under section 5111.01, 7776
5111.011,5162.20 or 5111.025163.15 of the Revised Code, in cash 7777
or in kind, including, but not limited to, a kickback or rebate, 7778
in connection with the furnishing of goods or services for which 7779
whole or partial reimbursement is or may be made under the medical 7780
assistancemedicaid program.7781

       (D) No person, having submitted a claim for or provided goods 7782
or services under the medical assistancemedicaid program, shall 7783
do either of the following for a period of at least six years 7784
after a reimbursement pursuant to that claim, or a reimbursement 7785
for those goods or services, is received under the medical 7786
assistancemedicaid program:7787

       (1) Knowingly alter, falsify, destroy, conceal, or remove any 7788
records that are necessary to fully disclose the nature of all7789
goods or services for which the claim was submitted, or for which7790
reimbursement was received, by the person;7791

       (2) Knowingly alter, falsify, destroy, conceal, or remove any 7792
records that are necessary to disclose fully all income and7793
expenditures upon which rates of reimbursements were based for the7794
person.7795

       (E) Whoever violates this section is guilty of medicaid7796
fraud. Except as otherwise provided in this division, medicaid7797
fraud is a misdemeanor of the first degree. If the value of7798
property, services, or funds obtained in violation of this section7799
is five hundred dollars or more and is less than five thousand7800
dollars, medicaid fraud is a felony of the fifth degree. If the7801
value of property, services, or funds obtained in violation of7802
this section is five thousand dollars or more and is less than one7803
hundred thousand dollars, medicaid fraud is a felony of the fourth7804
degree. If the value of the property, services, or funds obtained7805
in violation of this section is one hundred thousand dollars or7806
more, medicaid fraud is a felony of the third degree.7807

       (F) Upon application of the governmental agency, office, or7808
other entity that conducted the investigation and prosecution in a7809
case under this section, the court shall order any person who is7810
convicted of a violation of this section for receiving any7811
reimbursement for furnishing goods or services under the medical7812
assistancemedicaid program to which the person is not entitled to7813
pay to the applicant its cost of investigating and prosecuting the 7814
case. The costs of investigation and prosecution that a defendant 7815
is ordered to pay pursuant to this division shall be in addition 7816
to any other penalties for the receipt of that reimbursement that7817
are provided in this section, section 5111.035163.03 of the 7818
Revised Code, or any other provision of law.7819

       (G) The provisions of this section are not intended to be7820
exclusive remedies and do not preclude the use of any other7821
criminal or civil remedy for any act that is in violation of this7822
section.7823

       Sec. 2913.401.  (A) As used in this section:7824

       (1) "Medicaid benefits" means benefits under the medical 7825
assistancemedicaid program established under Chapter 5111. of the 7826
Revised Code.7827

       (2) "Property" means any real or personal property or other 7828
asset in which a person has any legal title or interest.7829

       (B) No person shall knowingly do any of the following in an 7830
application for medicaid benefits or in a document that requires a 7831
disclosure of assets for the purpose of determining eligibility to 7832
receive medicaid benefits:7833

       (1) Make or cause to be made a false or misleading statement;7834

       (2) Conceal an interest in property;7835

       (3)(a) Except as provided in division (B)(3)(b) of this 7836
section, fail to disclose a transfer of property that occurred 7837
during the period beginning thirty-six months before submission of 7838
the application or document and ending on the date the application 7839
or document was submitted;7840

       (b) Fail to disclose a transfer of property that occurred 7841
during the period beginning sixty months before submission of the 7842
application or document and ending on the date the application or 7843
document was submitted and that was made to an irrevocable trust a 7844
portion of which is not distributable to the applicant for 7845
medicaid benefits or the recipient of medicaid benefits or to a 7846
revocable trust.7847

       (C)(1) Whoever violates this section is guilty of medicaid 7848
eligibility fraud. Except as otherwise provided in this division, 7849
a violation of this section is a misdemeanor of the first degree. 7850
If the value of the medicaid benefits paid as a result of the 7851
violation is five hundred dollars or more and is less than five 7852
thousand dollars, a violation of this section is a felony of the 7853
fifth degree. If the value of the medicaid benefits paid as a 7854
result of the violation is five thousand dollars or more and is 7855
less than one hundred thousand dollars, a violation of this 7856
section is a felony of the fourth degree. If the value of the 7857
medicaid benefits paid as a result of the violation is one hundred 7858
thousand dollars or more, a violation of this section is a felony 7859
of the third degree.7860

       (2) In addition to imposing a sentence under division (C)(1) 7861
of this section, the court shall order that a person who is guilty 7862
of medicaid eligibility fraud make restitution in the full amount 7863
of any medicaid benefits paid on behalf of an applicant for or 7864
recipient of medicaid benefits for which the applicant or 7865
recipient was not eligible, plus interest at the rate applicable 7866
to judgments on unreimbursed amounts from the date on which the 7867
benefits were paid to the date on which restitution is made.7868

       (3) The remedies and penalties provided in this section are 7869
not exclusive and do not preclude the use of any other criminal or 7870
civil remedy for any act that is in violation of this section.7871

       (D) This section does not apply to a person who fully 7872
disclosed in an application for medicaid benefits or in a document 7873
that requires a disclosure of assets for the purpose of 7874
determining eligibility to receive medicaid benefits all of the 7875
interests in property of the applicant for or recipient of 7876
medicaid benefits, all transfers of property by the applicant for 7877
or recipient of medicaid benefits, and the circumstances of all 7878
those transfers.7879

       (E) Any amounts of medicaid benefits recovered as restitution 7880
under this section and any interest on those amounts shall be 7881
credited to the general revenue fund, and any applicable federal 7882
share shall be returned to the appropriate agency or department of 7883
the United States.7884

       Sec. 2921.01.  As used in sections 2921.01 to 2921.45 of the 7885
Revised Code:7886

       (A) "Public official" means any elected or appointed officer, 7887
or employee, or agent of the state or any political subdivision, 7888
whether in a temporary or permanent capacity, and includes, but is 7889
not limited to, legislators, judges, and law enforcement officers.7890

       (B) "Public servant" means any of the following:7891

       (1) Any public official;7892

       (2) Any person performing ad hoc a governmental function, 7893
including, but not limited to, a juror, member of a temporary 7894
commission, master, arbitrator, advisor, or consultant;7895

       (3) A person who is a candidate for public office, whether or 7896
not the person is elected or appointed to the office for which the 7897
person is a candidate. A person is a candidate for purposes of 7898
this division if the person has been nominated according to law 7899
for election or appointment to public office, or if the person has 7900
filed a petition or petitions as required by law to have the 7901
person's name placed on the ballot in a primary, general, or 7902
special election, or if the person campaigns as a write-in 7903
candidate in any primary, general, or special election.7904

       (C) "Party official" means any person who holds an elective 7905
or appointive post in a political party in the United States or 7906
this state, by virtue of which the person directs, conducts, or 7907
participates in directing or conducting party affairs at any level 7908
of responsibility.7909

       (D) "Official proceeding" means any proceeding before a 7910
legislative, judicial, administrative, or other governmental 7911
agency or official authorized to take evidence under oath, and 7912
includes any proceeding before a referee, hearing examiner, 7913
commissioner, notary, or other person taking testimony or a 7914
deposition in connection with an official proceeding.7915

       (E) "Detention" means arrest; confinement in any vehicle 7916
subsequent to an arrest; confinement in any public or private 7917
facility for custody of persons charged with or convicted of crime 7918
in this state or another state or under the laws of the United 7919
States or alleged or found to be a delinquent child or unruly 7920
child in this state or another state or under the laws of the 7921
United States; hospitalization, institutionalization, or 7922
confinement in any public or private facility that is ordered 7923
pursuant to or under the authority of section 2945.37, 2945.371, 7924
2945.38, 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised 7925
Code; confinement in any vehicle for transportation to or from any 7926
facility of any of those natures; detention for extradition or 7927
deportation; except as provided in this division, supervision by 7928
any employee of any facility of any of those natures that is 7929
incidental to hospitalization, institutionalization, or 7930
confinement in the facility but that occurs outside the facility; 7931
supervision by an employee of the department of rehabilitation and 7932
correction of a person on any type of release from a state 7933
correctional institution; or confinement in any vehicle, airplane, 7934
or place while being returned from outside of this state into this 7935
state by a private person or entity pursuant to a contract entered 7936
into under division (E) of section 311.29 of the Revised Code or 7937
division (B) of section 5149.03 of the Revised Code. For a person 7938
confined in a county jail who participates in a county jail 7939
industry program pursuant to section 5147.30 of the Revised Code, 7940
"detention" includes time spent at an assigned work site and going 7941
to and from the work site.7942

       (F) "Detention facility" means any public or private place 7943
used for the confinement of a person charged with or convicted of 7944
any crime in this state or another state or under the laws of the 7945
United States or alleged or found to be a delinquent child or 7946
unruly child in this state or another state or under the laws of 7947
the United States.7948

       (G) "Valuable thing or valuable benefit" includes, but is not 7949
limited to, a contribution. This inclusion does not indicate or 7950
imply that a contribution was not included in those terms before 7951
September 17, 1986.7952

       (H) "Campaign committee," "contribution," "political action 7953
committee," "legislative campaign fund," "political party," and 7954
"political contributing entity" have the same meanings as in 7955
section 3517.01 of the Revised Code.7956

       (I) "Provider agreement" and "medical assistance program" 7957
havehas the same meaningsmeaning as in section 2913.40 of the 7958
Revised Code.7959

       Sec. 2921.13.  (A) No person shall knowingly make a false7960
statement, or knowingly swear or affirm the truth of a false7961
statement previously made, when any of the following applies:7962

       (1) The statement is made in any official proceeding.7963

       (2) The statement is made with purpose to incriminate7964
another.7965

       (3) The statement is made with purpose to mislead a public7966
official in performing the public official's official function.7967

       (4) The statement is made with purpose to secure the payment7968
of unemployment compensation; Ohio works first; prevention,7969
retention, and contingency benefits and services; disability 7970
financial assistance; retirement benefits; economic development 7971
assistance, as defined in section 9.66 of the Revised Code; or 7972
other benefits administered by a governmental agency or paid out7973
of a public treasury.7974

       (5) The statement is made with purpose to secure the issuance 7975
by a governmental agency of a license, permit, authorization, 7976
certificate, registration, release, or provider agreement.7977

       (6) The statement is sworn or affirmed before a notary public 7978
or another person empowered to administer oaths.7979

       (7) The statement is in writing on or in connection with a7980
report or return that is required or authorized by law.7981

       (8) The statement is in writing and is made with purpose to7982
induce another to extend credit to or employ the offender, to7983
confer any degree, diploma, certificate of attainment, award of7984
excellence, or honor on the offender, or to extend to or bestow7985
upon the offender any other valuable benefit or distinction, when7986
the person to whom the statement is directed relies upon it to7987
that person's detriment.7988

       (9) The statement is made with purpose to commit or7989
facilitate the commission of a theft offense.7990

       (10) The statement is knowingly made to a probate court in7991
connection with any action, proceeding, or other matter within its7992
jurisdiction, either orally or in a written document, including,7993
but not limited to, an application, petition, complaint, or other7994
pleading, or an inventory, account, or report.7995

       (11) The statement is made on an account, form, record,7996
stamp, label, or other writing that is required by law.7997

       (12) The statement is made in connection with the purchase of 7998
a firearm, as defined in section 2923.11 of the Revised Code, and 7999
in conjunction with the furnishing to the seller of the firearm of 8000
a fictitious or altered driver's or commercial driver's license or 8001
permit, a fictitious or altered identification card, or any other 8002
document that contains false information about the purchaser's 8003
identity.8004

       (13) The statement is made in a document or instrument of8005
writing that purports to be a judgment, lien, or claim of8006
indebtedness and is filed or recorded with the secretary of state,8007
a county recorder, or the clerk of a court of record.8008

       (14) The statement is made with purpose to obtain an Ohio's 8009
best Rx program enrollment card under section 173.7735169.073 of 8010
the Revised Code or a payment under section 173.8015169.101 of 8011
the Revised Code.8012

       (15) The statement is made in an application filed with a8013
county sheriff pursuant to section 2923.125 of the Revised Code in8014
order to obtain or renew a license to carry a concealed handgun or 8015
is made in an affidavit submitted to a county sheriff to obtain a 8016
temporary emergency license to carry a concealed handgun under 8017
section 2923.1213 of the Revised Code.8018

       (16) The statement is required under section 5743.71 of the 8019
Revised Code in connection with the person's purchase of 8020
cigarettes or tobacco products in a delivery sale.8021

       (B) No person, in connection with the purchase of a firearm,8022
as defined in section 2923.11 of the Revised Code, shall knowingly8023
furnish to the seller of the firearm a fictitious or altered8024
driver's or commercial driver's license or permit, a fictitious or8025
altered identification card, or any other document that contains8026
false information about the purchaser's identity.8027

       (C) No person, in an attempt to obtain a license to carry a8028
concealed handgun under section 2923.125 of the Revised Code,8029
shall knowingly present to a sheriff a fictitious or altered8030
document that purports to be certification of the person's8031
competence in handling a handgun as described in division (B)(3)8032
of section 2923.125 of the Revised Code.8033

       (D) It is no defense to a charge under division (A)(6) of8034
this section that the oath or affirmation was administered or8035
taken in an irregular manner.8036

       (E) If contradictory statements relating to the same fact are 8037
made by the offender within the period of the statute of8038
limitations for falsification, it is not necessary for the8039
prosecution to prove which statement was false but only that one8040
or the other was false.8041

       (F)(1) Whoever violates division (A)(1), (2), (3), (4), (5),8042
(6), (7), (8), (10), (11), (13), (14), or (16) of this section is 8043
guilty of falsification, a misdemeanor of the first degree.8044

       (2) Whoever violates division (A)(9) of this section is8045
guilty of falsification in a theft offense. Except as otherwise8046
provided in this division, falsification in a theft offense is a8047
misdemeanor of the first degree. If the value of the property or8048
services stolen is five hundred dollars or more and is less than8049
five thousand dollars, falsification in a theft offense is a8050
felony of the fifth degree. If the value of the property or8051
services stolen is five thousand dollars or more and is less than8052
one hundred thousand dollars, falsification in a theft offense is8053
a felony of the fourth degree. If the value of the property or8054
services stolen is one hundred thousand dollars or more,8055
falsification in a theft offense is a felony of the third degree.8056

       (3) Whoever violates division (A)(12) or (B) of this section 8057
is guilty of falsification to purchase a firearm, a felony of the 8058
fifth degree.8059

       (4) Whoever violates division (A)(15) or (C) of this section 8060
is guilty of falsification to obtain a concealed handgun license, 8061
a felony of the fourth degree.8062

       (G) A person who violates this section is liable in a civil8063
action to any person harmed by the violation for injury, death, or8064
loss to person or property incurred as a result of the commission8065
of the offense and for reasonable attorney's fees, court costs,8066
and other expenses incurred as a result of prosecuting the civil8067
action commenced under this division. A civil action under this8068
division is not the exclusive remedy of a person who incurs8069
injury, death, or loss to person or property as a result of a8070
violation of this section.8071

       Sec. 2945.401.  (A) A defendant found incompetent to stand8072
trial and committed pursuant to section 2945.39 of the Revised 8073
Code or a person found not guilty by reason of insanity and 8074
committed pursuant to section 2945.40 of the Revised Code shall 8075
remain subject to the jurisdiction of the trial court pursuant to 8076
that commitment, and to the provisions of this section, until the 8077
final termination of the commitment as described in division 8078
(J)(1) of this section. If the jurisdiction is terminated under 8079
this division because of the final termination of the commitment8080
resulting from the expiration of the maximum prison term or term 8081
of imprisonment described in division (J)(1)(b) of this section, 8082
the court or prosecutor may file an affidavit for the civil 8083
commitment of the defendant or person pursuant to Chapter 5122. or 8084
5123. of the Revised Code.8085

       (B) A hearing conducted under any provision of sections8086
2945.37 to 2945.402 of the Revised Code shall not be conducted in 8087
accordance with Chapters 5122. and 5123. of the Revised Code. Any 8088
person who is committed pursuant to section 2945.39 or 2945.40 of 8089
the Revised Code shall not voluntarily admit the person or be 8090
voluntarily admitted to a hospital or institution pursuant to 8091
section 5122.02, 5122.15, 5123.69, or 5123.76 of the Revised Code. 8092
All other provisions of Chapters 5122. and 5123. of the Revised 8093
Code regarding hospitalization or institutionalization shall apply 8094
to the extent they are not in conflict with this chapter. A 8095
commitment under section 2945.39 or 2945.40 of the Revised Code 8096
shall not be terminated and the conditions of the commitment shall 8097
not be changed except as otherwise provided in division (D)(2) of 8098
this section with respect to a mentally retarded person subject to 8099
institutionalization by court order or except by order of the 8100
trial court.8101

       (C) The hospital, facility, or program to which a defendant 8102
or person has been committed under section 2945.39 or 2945.40 of 8103
the Revised Code shall report in writing to the trial court, at 8104
the times specified in this division, as to whether the defendant 8105
or person remains a mentally ill person subject to hospitalization 8106
by court order or a mentally retarded person subject to 8107
institutionalization by court order and, in the case of a8108
defendant committed under section 2945.39 of the Revised Code, as 8109
to whether the defendant remains incompetent to stand trial. The 8110
hospital, facility, or program shall make the reports after the 8111
initial six months of treatment and every two years after the 8112
initial report is made. The trial court shall provide copies of8113
the reports to the prosecutor and to the counsel for the defendant 8114
or person. Within thirty days after its receipt pursuant to this 8115
division of a report from a hospital, facility, or program, the 8116
trial court shall hold a hearing on the continued commitment of 8117
the defendant or person or on any changes in the conditions of the 8118
commitment of the defendant or person. The defendant or person may 8119
request a change in the conditions of confinement, and the trial 8120
court shall conduct a hearing on that request if six months or 8121
more have elapsed since the most recent hearing was conducted8122
under this section.8123

       (D)(1) Except as otherwise provided in division (D)(2) of 8124
this section, when a defendant or person has been committed under 8125
section 2945.39 or 2945.40 of the Revised Code, at any time after 8126
evaluating the risks to public safety and the welfare of the8127
defendant or person, the chief clinical officer of the hospital, 8128
facility, or program to which the defendant or person is committed 8129
may recommend a termination of the defendant's or person's 8130
commitment or a change in the conditions of the defendant's or 8131
person's commitment.8132

       Except as otherwise provided in division (D)(2) of this 8133
section, if the chief clinical officer recommends on-grounds8134
unsupervised movement, off-grounds supervised movement, or 8135
nonsecured status for the defendant or person or termination of 8136
the defendant's or person's commitment, the following provisions 8137
apply:8138

       (a) If the chief clinical officer recommends on-grounds 8139
unsupervised movement or off-grounds supervised movement, the 8140
chief clinical officer shall file with the trial court an 8141
application for approval of the movement and shall send a copy of 8142
the application to the prosecutor. Within fifteen days after 8143
receiving the application, the prosecutor may request a hearing on 8144
the application and, if a hearing is requested, shall so inform8145
the chief clinical officer. If the prosecutor does not request a 8146
hearing within the fifteen-day period, the trial court shall 8147
approve the application by entering its order approving the 8148
requested movement or, within five days after the expiration of 8149
the fifteen-day period, shall set a date for a hearing on the8150
application. If the prosecutor requests a hearing on the 8151
application within the fifteen-day period, the trial court shall 8152
hold a hearing on the application within thirty days after the 8153
hearing is requested. If the trial court, within five days after 8154
the expiration of the fifteen-day period, sets a date for a8155
hearing on the application, the trial court shall hold the hearing 8156
within thirty days after setting the hearing date. At least 8157
fifteen days before any hearing is held under this division, the 8158
trial court shall give the prosecutor written notice of the date, 8159
time, and place of the hearing. At the conclusion of each hearing 8160
conducted under this division, the trial court either shall 8161
approve or disapprove the application and shall enter its order 8162
accordingly.8163

       (b) If the chief clinical officer recommends termination of 8164
the defendant's or person's commitment at any time or if the chief8165
clinical officer recommends the first of any nonsecured status for 8166
the defendant or person, the chief clinical officer shall send 8167
written notice of this recommendation to the trial court and to 8168
the local forensic center. The local forensic center shall8169
evaluate the committed defendant or person and, within thirty days 8170
after its receipt of the written notice, shall submit to the trial 8171
court and the chief clinical officer a written report of the 8172
evaluation. The trial court shall provide a copy of the chief 8173
clinical officer's written notice and of the local forensic 8174
center's written report to the prosecutor and to the counsel for 8175
the defendant or person. Upon the local forensic center's8176
submission of the report to the trial court and the chief clinical 8177
officer, all of the following apply:8178

       (i) If the forensic center disagrees with the recommendation 8179
of the chief clinical officer, it shall inform the chief clinical 8180
officer and the trial court of its decision and the reasons for 8181
the decision. The chief clinical officer, after consideration of 8182
the forensic center's decision, shall either withdraw, proceed 8183
with, or modify and proceed with the recommendation. If the chief 8184
clinical officer proceeds with, or modifies and proceeds with, the8185
recommendation, the chief clinical officer shall proceed in 8186
accordance with division (D)(1)(b)(iii) of this section.8187

       (ii) If the forensic center agrees with the recommendation of 8188
the chief clinical officer, it shall inform the chief clinical 8189
officer and the trial court of its decision and the reasons for 8190
the decision, and the chief clinical officer shall proceed in 8191
accordance with division (D)(1)(b)(iii) of this section.8192

       (iii) If the forensic center disagrees with the 8193
recommendation of the chief clinical officer and the chief8194
clinical officer proceeds with, or modifies and proceeds with, the8195
recommendation or if the forensic center agrees with the 8196
recommendation of the chief clinical officer, the chief clinical 8197
officer shall work with the board of alcohol, drug addiction, and 8198
mental health services or community mental health board serving8199
the area, as appropriate, to develop a plan to implement the 8200
recommendation. If the defendant or person is on medication, the 8201
plan shall include, but shall not be limited to, a system to 8202
monitor the defendant's or person's compliance with the prescribed 8203
medication treatment plan. The system shall include a schedule 8204
that clearly states when the defendant or person shall report for 8205
a medication compliance check. The medication compliance checks 8206
shall be based upon the effective duration of the prescribed 8207
medication, taking into account the route by which it is taken, 8208
and shall be scheduled at intervals sufficiently close together to 8209
detect a potential increase in mental illness symptoms that the 8210
medication is intended to prevent.8211

       The chief clinical officer, after consultation with the board 8212
of alcohol, drug addiction, and mental health services or the8213
community mental health board serving the area, shall send the 8214
recommendation and plan developed under division (D)(1)(b)(iii) of8215
this section, in writing, to the trial court, the prosecutor and 8216
the counsel for the committed defendant or person. The trial court 8217
shall conduct a hearing on the recommendation and plan developed 8218
under division (D)(1)(b)(iii) of this section. Divisions (D)(1)(c) 8219
and (d) and (E) to (J) of this section apply regarding the8220
hearing.8221

       (c) If the chief clinical officer's recommendation is for 8222
nonsecured status or termination of commitment, the prosecutor may 8223
obtain an independent expert evaluation of the defendant's or8224
person's mental condition, and the trial court may continue the 8225
hearing on the recommendation for a period of not more than thirty 8226
days to permit time for the evaluation.8227

       The prosecutor may introduce the evaluation report or present 8228
other evidence at the hearing in accordance with the Rules of8229
Evidence.8230

       (d) The trial court shall schedule the hearing on a chief8231
clinical officer's recommendation for nonsecured status or 8232
termination of commitment and shall give reasonable notice to the 8233
prosecutor and the counsel for the defendant or person. Unless 8234
continued for independent evaluation at the prosecutor's request 8235
or for other good cause, the hearing shall be held within thirty 8236
days after the trial court's receipt of the recommendation and 8237
plan.8238

       (2)(a) Division (D)(1) of this section does not apply to8239
on-grounds unsupervised movement of a defendant or person who has 8240
been committed under section 2945.39 or 2945.40 of the Revised 8241
Code, who is a mentally retarded person subject to 8242
institutionalization by court order, and who is being provided 8243
residential habilitation, care, and treatment in a facility 8244
operated by the department of mental retardation and developmental8245
disabilities.8246

       (b) If, pursuant to section 2945.39 of the Revised Code, the 8247
trial court commits a defendant who is found incompetent to stand 8248
trial and who is a mentally retarded person subject to 8249
institutionalization by court order, if the defendant is being 8250
provided residential habilitation, care, and treatment in a 8251
facility operated by the department of mental retardation and8252
developmental disabilities, if an individual who is conducting a 8253
survey for the department of health to determine the facility's 8254
compliance with the certification requirements of the medicaid 8255
program under chapter 5111. of the Revised Code and Title XIX of 8256
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 8257
as amended, cites the defendant's receipt of the residential8258
habilitation, care, and treatment in the facility as being 8259
inappropriate under the certification requirements, if the 8260
defendant's receipt of the residential habilitation, care, and 8261
treatment in the facility potentially jeopardizes the facility's 8262
continued receipt of federal medicaid moneys, and if as a result 8263
of the citation the chief clinical officer of the facility 8264
determines that the conditions of the defendant's commitment 8265
should be changed, the department of mental retardation and 8266
developmental disabilities may cause the defendant to be removed 8267
from the particular facility and, after evaluating the risks to 8268
public safety and the welfare of the defendant and after 8269
determining whether another type of placement is consistent with 8270
the certification requirements, may place the defendant in another 8271
facility that the department selects as an appropriate facility 8272
for the defendant's continued receipt of residential habilitation,8273
care, and treatment and that is a no less secure setting than the 8274
facility in which the defendant had been placed at the time of the 8275
citation. Within three days after the defendant's removal and 8276
alternative placement under the circumstances described in 8277
division (D)(2)(b) of this section, the department of mental 8278
retardation and developmental disabilities shall notify the trial 8279
court and the prosecutor in writing of the removal and alternative 8280
placement.8281

       The trial court shall set a date for a hearing on the removal 8282
and alternative placement, and the hearing shall be held within 8283
twenty-one days after the trial court's receipt of the notice from 8284
the department of mental retardation and developmental 8285
disabilities. At least ten-daysten days before the hearing is 8286
held, the trial court shall give the prosecutor, the department of 8287
mental retardation and developmental disabilities, and the counsel 8288
for the defendant written notice of the date, time, and place of 8289
the hearing. At the hearing, the trial court shall consider the 8290
citation issued by the individual who conducted the survey for the 8291
department of health to be prima-facie evidence of the fact that 8292
the defendant's commitment to the particular facility was 8293
inappropriate under the certification requirements of the medicaid 8294
program under Chapter 5111. of the Revised Code and Title XIX of 8295
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 8296
as amended, and potentially jeopardizes the particular facility's8297
continued receipt of federal medicaid moneys. At the conclusion of 8298
the hearing, the trial court may approve or disapprove the 8299
defendant's removal and alternative placement. If the trial court 8300
approves the defendant's removal and alternative placement, the 8301
department of mental retardation and developmental disabilities 8302
may continue the defendant's alternative placement. If the trial 8303
court disapproves the defendant's removal and alternative 8304
placement, it shall enter an order modifying the defendant's8305
removal and alternative placement, but that order shall not 8306
require the department of mental retardation and developmental 8307
disabilities to replace the defendant for purposes of continued8308
residential habilitation, care, and treatment in the facility 8309
associated with the citation issued by the individual who 8310
conducted the survey for the department of health.8311

       (E) In making a determination under this section regarding 8312
nonsecured status or termination of commitment, the trial court 8313
shall consider all relevant factors, including, but not limited 8314
to, all of the following:8315

       (1) Whether, in the trial court's view, the defendant or 8316
person currently represents a substantial risk of physical harm to 8317
the defendant or person or others;8318

       (2) Psychiatric and medical testimony as to the current 8319
mental and physical condition of the defendant or person;8320

       (3) Whether the defendant or person has insight into the 8321
dependant's or person's condition so that the defendant or person 8322
will continue treatment as prescribed or seek professional 8323
assistance as needed;8324

       (4) The grounds upon which the state relies for the proposed8325
commitment;8326

       (5) Any past history that is relevant to establish the 8327
defendant's or person's degree of conformity to the laws, rules, 8328
regulations, and values of society;8329

       (6) If there is evidence that the defendant's or person's 8330
mental illness is in a state of remission, the medically suggested 8331
cause and degree of the remission and the probability that the 8332
defendant or person will continue treatment to maintain the 8333
remissive state of the defendant's or person's illness should the 8334
defendant's or person's commitment conditions be altered.8335

       (F) At any hearing held pursuant to division (C) or (D)(1) or 8336
(2) of this section, the defendant or the person shall have all 8337
the rights of a defendant or person at a commitment hearing as 8338
described in section 2945.40 of the Revised Code.8339

       (G) In a hearing held pursuant to division (C) or (D)(1) of 8340
this section, the prosecutor has the burden of proof as follows:8341

       (1) For a recommendation of termination of commitment, to 8342
show by clear and convincing evidence that the defendant or person 8343
remains a mentally ill person subject to hospitalization by court 8344
order or a mentally retarded person subject to 8345
institutionalization by court order;8346

       (2) For a recommendation for a change in the conditions of 8347
the commitment to a less restrictive status, to show by clear and 8348
convincing evidence that the proposed change represents a threat 8349
to public safety or a threat to the safety of any person.8350

       (H) In a hearing held pursuant to division (C) or (D)(1) or 8351
(2) of this section, the prosecutor shall represent the state or 8352
the public interest.8353

       (I) At the conclusion of a hearing conducted under division 8354
(D)(1) of this section regarding a recommendation from the chief8355
clinical officer of a hospital, program, or facility, the trial 8356
court may approve, disapprove, or modify the recommendation and 8357
shall enter an order accordingly.8358

       (J)(1) A defendant or person who has been committed pursuant 8359
to section 2945.39 or 2945.40 of the Revised Code continues to be 8360
under the jurisdiction of the trial court until the final8361
termination of the commitment. For purposes of division (J) of 8362
this section, the final termination of a commitment occurs upon 8363
the earlier of one of the following:8364

       (a) The defendant or person no longer is a mentally ill 8365
person subject to hospitalization by court order or a mentally8366
retarded person subject to institutionalization by court order, as 8367
determined by the trial court;8368

       (b) The expiration of the maximum prison term or term of 8369
imprisonment that the defendant or person could have received if 8370
the defendant or person had been convicted of the most serious 8371
offense with which the defendant or person is charged or in 8372
relation to which the defendant or person was found not guilty by 8373
reason of insanity;8374

       (c) The trial court enters an order terminating the8375
commitment under the circumstances described in division8376
(J)(2)(a)(ii) of this section.8377

       (2)(a) If a defendant is found incompetent to stand trial and 8378
committed pursuant to section 2945.39 of the Revised Code, if 8379
neither of the circumstances described in divisions (J)(1)(a) and 8380
(b) of this section applies to that defendant, and if a report 8381
filed with the trial court pursuant to division (C) of this8382
section indicates that the defendant presently is competent to8383
stand trial or if, at any other time during the period of the8384
defendant's commitment, the prosecutor, the counsel for the8385
defendant, or the chief clinical officer of the hospital,8386
facility, or program to which the defendant is committed files an 8387
application with the trial court alleging that the defendant8388
presently is competent to stand trial and requesting a hearing on 8389
the competency issue or the trial court otherwise has reasonable 8390
cause to believe that the defendant presently is competent to 8391
stand trial and determines on its own motion to hold a hearing on 8392
the competency issue, the trial court shall schedule a hearing on 8393
the competency of the defendant to stand trial, shall give the 8394
prosecutor, the counsel for the defendant, and the chief clinical 8395
officer notice of the date, time, and place of the hearing at 8396
least fifteen days before the hearing, and shall conduct the 8397
hearing within thirty days of the filing of the application or of 8398
its own motion. If, at the conclusion of the hearing, the trial 8399
court determines that the defendant presently is capable of 8400
understanding the nature and objective of the proceedings against 8401
the defendant and of assisting in the defendant's defense, the 8402
trial court shall order that the defendant is competent to stand 8403
trial and shall be proceeded against as provided by law with 8404
respect to the applicable offenses described in division (C)(1) of 8405
section 2945.38 of the Revised Code and shall enter whichever of8406
the following additional orders is appropriate:8407

       (i) If the trial court determines that the defendant remains 8408
a mentally ill person subject to hospitalization by court order or 8409
a mentally retarded person subject to institutionalization by 8410
court order, the trial court shall order that the defendant's 8411
commitment to the hospital, facility, or program be continued 8412
during the pendency of the trial on the applicable offenses 8413
described in division (C)(1) of section 2945.38 of the Revised 8414
Code.8415

       (ii) If the trial court determines that the defendant no8416
longer is a mentally ill person subject to hospitalization by8417
court order or a mentally retarded person subject to8418
institutionalization by court order, the trial court shall order8419
that the defendant's commitment to the hospital, facility, or8420
program shall not be continued during the pendency of the trial on 8421
the applicable offenses described in division (C)(1) of section 8422
2945.38 of the Revised Code. This order shall be a final 8423
termination of the commitment for purposes of division (J)(1)(c) 8424
of this section.8425

       (b) If, at the conclusion of the hearing described in8426
division (J)(2)(a) of this section, the trial court determines 8427
that the defendant remains incapable of understanding the nature 8428
and objective of the proceedings against the defendant or of 8429
assisting in the defendant's defense, the trial court shall order 8430
that the defendant continues to be incompetent to stand trial, 8431
that the defendant's commitment to the hospital, facility, or 8432
program shall be continued, and that the defendant remains subject 8433
to the jurisdiction of the trial court pursuant to that 8434
commitment, and to the provisions of this section, until the final 8435
termination of the commitment as described in division (J)(1) of 8436
this section.8437

       Sec. 3101.051.  (A) Except as provided in division (B) of 8438
this section, a probate court shall make available to any person 8439
for inspection the records pertaining to the issuance of marriage 8440
licenses as provided under section 149.43 of the Revised Code.8441

       (B) Before it makes available to a person any records 8442
pertaining to the issuance of a marriage license as described in 8443
division (A) of this section, subject to division (C) of this 8444
section, a probate court shall delete or otherwise remove any 8445
social security numbers of the parties to a marriage so that they 8446
are not available to the person inspecting the records.8447

       (C) Division (B) of this section does not apply in any of the 8448
following circumstances:8449

       (1) If the records in question are inspected by authorized 8450
personnel of the division of child support in the department of 8451
job and family services under section 5101.313125.41 of the 8452
Revised Code;8453

       (2) If the records in question are inspected by law 8454
enforcement personnel for purposes of a criminal investigation;8455

       (3) If the records in question with the social security 8456
numbers are necessary for use in a civil or criminal trial and the 8457
release of the records with the social security numbers is ordered 8458
by a court with jurisdiction over the trial;8459

       (4) If the records in question are inspected by either party 8460
to the marriage to which the records pertain;8461

       (5) If the court possessed the records in question prior to 8462
the effective date of this sectionFebruary 12, 2001.8463

       Sec. 3107.083.  Not later than ninety days after June 20,8464
1996, the director of job and family services shall do all of the8465
following:8466

       (A)(1) For a parent of a child who, if adopted, will be an8467
adopted person as defined in section 3107.45 of the Revised Code,8468
prescribe a form that has the following six components:8469

       (a) A component the parent signs under section 3107.071,8470
3107.081, or 5103.151 of the Revised Code to indicate the8471
requirements of section 3107.082 or 5103.152 of the Revised Code8472
have been met. The component shall be as follows:8473

"Statement Concerning Ohio Law and Adoption Materials
8474

       By signing this component of this form, I acknowledge that it8475
has been explained to me, and I understand, that, if I check the8476
space on the next component of this form that indicates that I8477
authorize the release, the adoption file maintained by the Ohio8478
Department of Health, which contains identifying information about8479
me at the time of my child's birth, will be released, on request,8480
to the adoptive parent when the adoptee is at least age eighteen8481
but younger than age twenty-one and to the adoptee when he or she8482
is age twenty-one or older. It has also been explained to me, and8483
I understand, that I may prohibit the release of identifying8484
information about me contained in the adoption file by checking8485
the space on the next component of this form that indicates that I8486
do not authorize the release of the identifying information. It8487
has additionally been explained to me, and I understand, that I8488
may change my mind regarding the decision I make on the next8489
component of this form at any time and as many times as I desire8490
by signing, dating, and having filed with the Ohio Department of8491
Health a denial of release form or authorization of release form8492
prescribed and provided by the Department of Health and providing8493
the Department two items of identification.8494

       By signing this component of this form, I also acknowledge8495
that I have been provided a copy of written materials about8496
adoption prepared by the Ohio Department of Job and Family8497
Services, the adoption process and ramifications of consenting to8498
adoption or entering into a voluntary permanent custody surrender8499
agreement have been discussed with me, and I have been provided8500
the opportunity to review the materials and ask questions about8501
the materials and discussion.8502

Signature of biological parent: 8503
Signature of witness: 8504
Date: " 8505

       (b) A component the parent signs under section 3107.071,8506
3107.081, or 5103.151 of the Revised Code regarding the parent's8507
decision whether to allow identifying information about the parent8508
contained in an adoption file maintained by the department of8509
health to be released to the parent's child and adoptive parent8510
pursuant to section 3107.47 of the Revised Code. The component8511
shall be as follows:8512

"Statement Regarding Release of Identifying Information
8513

       The purpose of this component of this form is to allow a8514
biological parent to decide whether to allow the Ohio Department8515
of Health to provide an adoptee and adoptive parent identifying8516
information about the adoptee's biological parent contained in an8517
adoption file maintained by the Department. Please check one of8518
the following spaces:8519

...... YES, I authorize the Ohio Department of Health to release identifying information about me, on request, to the adoptive parent when the adoptee is at least age eighteen but younger than age twenty-one and to the adoptee when he or she is age twenty-one or older. 8520
...... NO, I do not authorize the release of identifying information about me to the adoptive parent or adoptee. 8521

Signature of biological parent: 8522
Signature of witness: 8523
Date: " 8524

       (c) A component the parent, if the mother of the child,8525
completes and signs under section 3107.071, 3107.081, or 5103.1518526
of the Revised Code to indicate, to the extent of the mother's8527
knowledge, all of the following:8528

       (i) Whether the mother, during her pregnancy, was a recipient 8529
of the medical assistancemedicaid program established under8530
Chapter 5111. of the Revised Code or other public health insurance8531
program and, if so, the dates her eligibility began and ended;8532

       (ii) Whether the mother, during her pregnancy, was covered by8533
private health insurance and, if so, the dates the coverage began 8534
and ended, the name of the insurance provider, the type of8535
coverage, and the identification number of the coverage;8536

       (iii) The name and location of the hospital, freestanding8537
birth center, or other place where the mother gave birth and, if8538
different, received medical care immediately after giving birth;8539

       (iv) The expenses of the obstetrical and neonatal care;8540

       (v) Whether the mother has been informed that the adoptive8541
parent or the agency or attorney arranging the adoption are to pay8542
expenses involved in the adoption, including expenses the mother8543
has paid and expects to receive or has received reimbursement,8544
and, if so, what expenses are to be or have been paid and an8545
estimate of the expenses;8546

       (vi) Any other information related to expenses the department8547
determines appropriate to be included in this component.8548

       (d) A component the parent may sign to authorize the agency8549
or attorney arranging the adoption to provide to the child or8550
adoptive parent materials, other than photographs of the parent,8551
that the parent requests be given to the child or adoptive parent8552
pursuant to section 3107.68 of the Revised Code.8553

       (e) A component the parent may sign to authorize the agency8554
or attorney arranging the adoption to provide to the child or8555
adoptive parent photographs of the parent pursuant to section8556
3107.68 of the Revised Code.8557

       (f) A component the parent may sign to authorize the agency8558
or attorney arranging the adoption to provide to the child or8559
adoptive parent the first name of the parent pursuant to section8560
3107.68 of the Revised Code.8561

       (2) State at the bottom of the form that the parent is to8562
receive a copy of the form the parent signed.8563

       (3) Provide copies of the form prescribed under this division8564
to probate and juvenile courts, public children services agencies, 8565
private child placing agencies, private noncustodial agencies, 8566
attorneys, and persons authorized to take acknowledgments.8567

       (B)(1) For a parent of a child who, if adopted, will become8568
an adopted person as defined in section 3107.39 of the Revised8569
Code, prescribe a form that has the following five components:8570

       (a) A component the parent signs under section 3107.071,8571
3107.081, or 5103.151 of the Revised Code to attest that the8572
requirement of division (A) of section 3107.082 or division (A) of8573
section 5103.152 of the Revised Code has been met;8574

       (b) A component the parent, if the mother of the child,8575
completes and signs under section 3107.071, 3107.081, or 5103.1518576
of the Revised Code to indicate, to the extent of the mother's8577
knowledge, all of the following:8578

       (i) Whether the mother, during her pregnancy, was a recipient 8579
of the medical assistancemedicaid program established under8580
Chapter 5111. of the Revised Code or other public health insurance8581
program and, if so, the dates her eligibility began and ended;8582

       (ii) Whether the mother, during her pregnancy, was covered by8583
private health insurance and, if so, the dates the coverage began 8584
and ended, the name of the insurance provider, the type of8585
coverage, and the identification number of the coverage;8586

       (iii) The name and location of the hospital, freestanding8587
birth center, or other place where the mother gave birth and, if8588
different, received medical care immediately after giving birth;8589

       (iv) The expenses of the obstetrical and neonatal care;8590

       (v) Whether the mother has been informed that the adoptive8591
parent or the agency or attorney arranging the adoption are to pay8592
expenses involved in the adoption, including expenses the mother8593
has paid and expects to receive or has received reimbursement for,8594
and, if so, what expenses are to be or have been paid and an8595
estimate of the expenses;8596

       (vi) Any other information related to expenses the department8597
determines appropriate to be included in the component.8598

       (c) A component the parent may sign to authorize the agency8599
or attorney arranging the adoption to provide to the child or8600
adoptive parent materials, other than photographs of the parent,8601
that the parent requests be given to the child or adoptive parent8602
pursuant to section 3107.68 of the Revised Code.8603

       (d) A component the parent may sign to authorize the agency8604
or attorney arranging the adoption to provide to the child or8605
adoptive parent photographs of the parent pursuant to section8606
3107.68 of the Revised Code.8607

       (e) A component the parent may sign to authorize the agency8608
or attorney arranging the adoption to provide to the child or8609
adoptive parent the first name of the parent pursuant to section8610
3107.68 of the Revised Code.8611

       (2) State at the bottom of the form that the parent is to8612
receive a copy of the form the parent signed.8613

       (3) Provide copies of the form prescribed under this division 8614
to probate and juvenile courts, public children services agencies, 8615
private child placing agencies, private noncustodial agencies, and 8616
attorneys.8617

       (C) Prepare the written materials about adoption that are8618
required to be given to parents under division (A) of section8619
3107.082 and division (A) of section 5103.152 of the Revised Code.8620
The materials shall provide information about the adoption8621
process, including ramifications of a parent consenting to a8622
child's adoption or entering into a voluntary permanent custody8623
surrender agreement. The materials also shall include referral8624
information for professional counseling and adoption support8625
organizations. The director shall provide the materials to8626
assessors.8627

       (D) Adopt rules in accordance with Chapter 119. of the8628
Revised Code specifying the documents that must be filed with a8629
probate court under divisions (B) and (D) of section 3107.081 of8630
the Revised Code and a juvenile court under divisions (C) and (E)8631
of section 5103.151 of the Revised Code.8632

       Sec. 3111.04.  (A) An action to determine the existence or8633
nonexistence of the father and child relationship may be brought8634
by the child or the child's personal representative, the child's8635
mother or her personal representative, a man alleged or alleging8636
himself to be the child's father, the child support enforcement8637
agency of the county in which the child resides if the child's8638
mother, father, or alleged father is a recipient of public 8639
assistance or of services under Title IV-D of the "Social Security 8640
Act," 88 Stat. 2351 (1975), 42 U.S.C.A. 651, as amended, or the 8641
alleged father's personal representative.8642

       (B) An agreement does not bar an action under this section.8643

       (C) If an action under this section is brought before the8644
birth of the child and if the action is contested, all8645
proceedings, except service of process and the taking of8646
depositions to perpetuate testimony, may be stayed until after the 8647
birth.8648

       (D) A recipient of public assistance or of services under 8649
Title IV-D of the "Social Security Act," 88 Stat. 2351 (1975), 42 8650
U.S.C.A. 651, as amended, shall cooperate with the child support8651
enforcement agency of the county in which a child resides to 8652
obtain an administrative determination pursuant to sections 8653
3111.38 to 3111.54 of the Revised Code, or, if necessary, a court8654
determination pursuant to sections 3111.01 to 3111.18 of the 8655
Revised Code, of the existence or nonexistence of a parent and8656
child relationship between the father and the child. If the 8657
recipient fails to cooperate, the agency may commence an action to 8658
determine the existence or nonexistence of a parent and child 8659
relationship between the father and the child pursuant to sections 8660
3111.01 to 3111.18 of the Revised Code.8661

       (E) As used in this section, "public assistance" means all 8662
of the following:8663

       (1) Medicaid under Chapter 5111. of the Revised Code;8664

       (2) Ohio works first under Chapter 5107. of the Revised Code;8665

       (3) Disability financial assistance under Chapter 5115. of 8666
the Revised Code;8667

       (4) Disability medical assistance under Chapter 5115. of the 8668
Revised Code;8669

       (5) Children's buy-in program under sections 5101.5211 to 8670
5101.5216 of the Revised Code.8671

       Sec. 3111.72.  The contract between the department of job and 8672
family services and a local hospital shall require all of the8673
following:8674

       (A) That the hospital provide a staff person to meet with 8675
each unmarried mother who gave birth in or en route to the 8676
hospital within twenty-four hours of the birth or before the 8677
mother is released from the hospital;8678

       (B) That the staff person attempt to meet with the father of 8679
the unmarried mother's child if possible;8680

       (C) That the staff person explain to the unmarried mother and 8681
the father, if he is present, the benefit to the child of8682
establishing a parent and child relationship between the father8683
and the child and the various proper procedures for establishing a 8684
parent and child relationship;8685

       (D) That the staff person present to the unmarried mother8686
and, if possible, the father, the pamphlet or statement regarding8687
the rights and responsibilities of a natural parent that is8688
prepared and provided by the department of job and family services 8689
pursuant to section 3111.32 of the Revised Code;8690

       (E) That the staff person provide the mother and, if8691
possible, the father, all forms and statements necessary to 8692
voluntarily establish a parent and child relationship, including, 8693
but not limited to, the acknowledgment of paternity affidavit 8694
prepared by the department of job and family services pursuant to 8695
section 3111.31 of the Revised Code;8696

       (F) That the staff person, at the request of both the mother 8697
and father, help the mother and father complete any form or8698
statement necessary to establish a parent and child relationship;8699

       (G) That the hospital provide a notary public to notarize an8700
acknowledgment of paternity affidavit signed by the mother and8701
father;8702

       (H) That the staff person present to an unmarried mother who 8703
is not participating in the Ohio works first program established8704
under Chapter 5107. or receiving medical assistance under Chapter8705
5111. of the Revised Codemedicaid an application for Title IV-D 8706
services;8707

       (I) That the staff person forward any completed8708
acknowledgment of paternity, no later than ten days after it is8709
completed, to the office of child support in the department of job 8710
and family services;8711

       (J) That the department of job and family services pay the8712
hospital twenty dollars for every correctly signed and notarized 8713
acknowledgment of paternity affidavit from the hospital.8714

       Sec. 3113.06.  No father, or mother when she is charged with 8715
the maintenance, of a child under eighteen years of age, or a 8716
mentally or physically handicapped child under age twenty-one, who 8717
is legally a ward of a public children services agency or is the 8718
recipient of aid pursuant to sections 5101.52115167.35 to 8719
5101.52165167.40 or Chapter 5107. or, 5115., or 5168. of the 8720
Revised Code, shall neglect or refuse to pay such agency the 8721
reasonable cost of maintaining such child when such father or 8722
mother is able to do so by reason of property, labor, or 8723
earnings.8724

       An offense under this section shall be held committed in the 8725
county in which the agency is located. The agency shall file 8726
charges against any parent who violates this section, unless the8727
agency files charges under section 2919.21 of the Revised Code, or 8728
unless charges of nonsupport are filed by a relative or guardian 8729
of the child, or unless an action to enforce support is brought 8730
under Chapter 3115. of the Revised Code.8731

       Sec. 3119.29. (A) As used in this section and sections 8732
3119.30 to 3119.56 of the Revised Code:8733

       (1) "Cash medical support" means an amount ordered to be 8734
paid in a child support order toward the cost of health insurance 8735
provided by a public entity, another parent, or person with whom 8736
the child resides, through employment or otherwise, or for other 8737
medical cost not covered by insurance.8738

       (2) "Federal poverty line" has the same meaning as defined in 8739
section 5104.01 of the Revised Code.8740

       (3) "Health care" means such medical support that includes 8741
coverage under a health insurance plan, payment of costs of 8742
premiums, co-paymentscopayments, and deductibles, or payment for 8743
medical expenses incurred on behalf of the child.8744

       (4) "Health insurance coverage" means accessible private 8745
health insurance that provides primary care services within thirty 8746
miles from the residence of the child subject to the child support 8747
order.8748

       (5) "Health plan administrator" means any entity authorized8749
under Title XXXIX of the Revised Code to engage in the business of8750
insurance in this state, any health insuring corporation, any8751
legal entity that is self-insured and provides benefits to its8752
employees or members, and the administrator of any such entity or8753
corporation.8754

       (6) "National medical support notice" means a form required8755
by the "Child Support Performance and Incentive Act of 1998," 8756
P.L. 105-200, 112 Stat. 659, 42 U.S.C. 666(a)(19), as amended, 8757
and jointly developed and promulgated by the secretary of health 8758
and human services and the secretary of labor in federal 8759
regulations adopted under that act as modified by the department 8760
of job and family services under section 3119.291 of the Revised 8761
Code.8762

       (7) "Person required to provide health insurance coverage"8763
means the obligor, obligee, or both, required by the court under a8764
court child support order or by the child support enforcement8765
agency under an administrative child support order to provide8766
health insurance coverage pursuant to section 3119.30 of the8767
Revised Code.8768

       (8) Subject to division (B) of this section, "reasonable 8769
cost" means the contributing cost of private family health 8770
insurance to the person responsible for the health care of the 8771
children subject to the child support order that does not exceed 8772
an amount equal to five per cent of the annual gross income of 8773
that person.8774

       (9) "Title XIX" has the same meaning as defined in section 8775
5111.205164.01 of the Revised Code.8776

       (B) If the United States secretary of health and human 8777
services issues a regulation defining "reasonable cost" or a 8778
similar term or phrase relevant to the provisions in child support 8779
orders relating to the provision of health care for children 8780
subject to the orders, and if that definition is substantively 8781
different from the meaning of "reasonable cost" as defined in 8782
division (A) of this section, "reasonable cost" as used in this 8783
section shall have the meaning as defined by the United States 8784
secretary of health and human services.8785

       Sec. 3119.54.  A party to a child support order issued in8786
accordance with section 3119.30 of the Revised Code shall notify 8787
any physician, hospital, or other provider of medical services 8788
that provides medical services to the child who is the subject of 8789
the child support order of the number of any health insurance or 8790
health care policy, contract, or plan that covers the child if the 8791
child is eligible for medical assistance under sections 5101.5211 8792
to 5101.5216 or Chapter 5111. or 5115. of the Revised Codethe 8793
medicaid program, the disability medical assistance program, or 8794
the children's buy-in program. The party shall include in the 8795
notice the name and address of the insurer. Any physician, 8796
hospital, or other provider of medical services for which medical 8797
assistance is available under sections 5101.5211 to 5101.5216 or 8798
Chapter 5111. or 5115. of the Revised Codethe medicaid program, 8799
the disability medical assistance program, or the children's 8800
buy-in program who is notified under this section of the existence 8801
of a health insurance or health care policy, contract, or plan 8802
with coverage for children who are eligible for medical8803
assistance shall first bill the insurer for any services provided8804
for those children. If the insurer fails to pay all or any part8805
of a claim filed under this section and the services for which 8806
the claim is filed are covered by sections 5101.5211 to 5101.5216 8807
or Chapter 5111. or 5115. of the Revised Codethe medicaid 8808
program, the disability medical assistance program, or the 8809
children's buy-in program, the physician, hospital, or other8810
medical services provider shall bill the remaining unpaid costs 8811
of the services in accordance with sections 5101.5211 to 8812
5101.5216 or Chapter 5111. or 5115. of the Revised Codethe law 8813
governing the medicaid program, disability medical assistance 8814
program, or children's buy-in program.8815

       Sec. 3121.441. (A) Notwithstanding the provisions of this8816
chapter, Chapters 3119., 3123., and 3125., and sections 3770.0718817
and 5107.20 of the Revised Code providing for the office of child8818
support in the department of job and family services to collect,8819
withhold, or deduct spousal support, when a court pursuant to8820
section 3105.18 or 3105.65 of the Revised Code issues or modifies8821
an order requiring an obligor to pay spousal support or grants or8822
modifies a decree of dissolution of marriage incorporating a8823
separation agreement that provides for spousal support, or at any8824
time after the issuance, granting, or modification of an order or8825
decree of that type, the court may permit the obligor to make the8826
spousal support payments directly to the obligee instead of to the8827
office if the obligee and the obligor have no minor children born8828
as a result of their marriage and the obligee has not assigned the8829
spousal support amounts to the department pursuant to section8830
5101.59 or 5107.20 or 5160.37 of the Revised Code.8831

       (B) A court that permits an obligor to make spousal support8832
payments directly to the obligee pursuant to division (A) of this8833
section shall order the obligor to make the spousal support8834
payments as a check, as a money order, or in any other form that8835
establishes a clear record of payment.8836

       (C) If a court permits an obligor to make spousal support8837
payments directly to an obligee pursuant to division (A) of this8838
section and the obligor is in default in making any spousal8839
support payment to the obligee, the court, upon motion of the8840
obligee or on its own motion, may rescind the permission granted8841
under that division. After the rescission, the court shall8842
determine the amount of arrearages in the spousal support payments8843
and order the obligor to make to the office of child support in8844
the department of job and family services any spousal support8845
payments that are in arrears and any future spousal support8846
payments. Upon the issuance of the order of the court under this8847
division, the provisions of this chapter, Chapters 3119., 3123.,8848
and 3125., and sections 3770.071 and 5107.20 of the Revised Code8849
apply with respect to the collection, withholding, or deduction of8850
the obligor's spousal support payments that are the subject of8851
that order of the court.8852

       Sec. 3121.898. TheAs used in this section, "state agency" 8853
means every department, bureau, board, commission, office, or 8854
other organized body established by the constitution or laws of 8855
this state for the exercise of state government; every entity of 8856
county government that is subject to the rules of a state agency; 8857
and every contractual agent of a state agency.8858

       The department of job and family services shall use the new8859
hire reports it receives for any of the following purposes set 8860
forth in 42 U.S.C. 653a, as amended, including:8861

       (A) To locate individuals for the purposes of establishing 8862
paternity and for establishing, modifying, and enforcing child 8863
support orders.8864

       (B) As used in this division, "state agency" means every 8865
department, bureau, board, commission, office, or other organized 8866
body established by the constitution or laws of this state for the 8867
exercise of state government; every entity of county government 8868
that is subject to the rules of a state agency; and every 8869
contractual agent of a state agency.8870

       To make available to any state agency responsible for 8871
administering any of the following programs for purposes of 8872
verifying program eligibility:8873

       (1) Any Title IV-A program as defined in section 5101.80 of 8874
the Revised Code;8875

       (2) The medicaid program authorized by Chapter 5111. of the 8876
Revised Code;8877

       (3) The unemployment compensation program authorized by 8878
Chapter 4141. of the Revised Code;8879

       (4) The food stamp program authorized by section 5101.54 of 8880
the Revised Code;8881

       (5) Any other program authorized in 42 U.S.C. 1320b-7(b), as 8882
amended.8883

       (C) The administration of the employment security program 8884
under the director of job and family services.8885

       Sec. 3125.36.  (A) Subject to division (B) of this section, 8886
all support orders that are administered by a child support8887
enforcement agency designated under section 307.981 of the Revised 8888
Code or former section 2301.35 of the Revised Code and are8889
eligible for Title IV-D services shall be Title IV-D cases under 8890
Title IV-D of the "Social Security Act." Subject to division (B) 8891
of this section, all obligees of support orders administered by 8892
the agency shall be considered to have filed a signed application 8893
for Title IV-D services.8894

       (B) Except as provided in division (D) of this section, a 8895
court that issues or modifies a support order shall require the 8896
obligee under the order to sign, at the time of the issuance or 8897
modification of the order, an application for Title IV-D services 8898
and to file, as soon as possible, the signed application with the 8899
child support enforcement agency that will administer the order. 8900
The application shall be on a form prescribed by the department of8901
job and family services. Except as provided in division (D) of8902
this section, a support order that is administered by a child 8903
support enforcement agency, and that is eligible for Title IV-D 8904
services shall be a Title IV-D case under Title IV-D of the 8905
"Social Security Act" only upon the filing of the signed 8906
application for Title IV-D services.8907

       (C) A child support enforcement agency shall make available 8908
an application for Title IV-D services to all persons requesting a 8909
child support enforcement agency's assistance in an action under 8910
sections 3111.01 to 3111.18 of the Revised Code or in an 8911
administrative proceeding brought to establish a parent and child8912
relationship, to establish or modify an administrative support 8913
order, or to establish or modify an order to provide health 8914
insurance coverage for the children subject to a support order.8915

       (D) An obligee under a support order who has assigned the 8916
right to the support pursuant to section 5101.59 or 5107.20 or 8917
5160.37 of the Revised Code shall not be required to sign an 8918
application for Title IV-D services. The support order shall be 8919
considered a Title IV-D case.8920

       Sec. 3307.20.  (A) As used in this section:8921

       (1) "Personal history record" means information maintained by 8922
the state teachers retirement board on an individual who is a8923
member, former member, contributor, former contributor, retirant,8924
or beneficiary that includes the address, telephone number, social8925
security number, record of contributions, correspondence with the8926
state teachers retirement system, or other information the board8927
determines to be confidential.8928

       (2) "Retirant" has the same meaning as in section 3307.50 of8929
the Revised Code.8930

       (B) The records of the board shall be open to public8931
inspection, except for the following, which shall be excluded,8932
except with the written authorization of the individual concerned:8933

       (1) The individual's personal records provided for in section 8934
3307.23 of the Revised Code;8935

       (2) The individual's personal history record;8936

       (3) Any information identifying, by name and address, the8937
amount of a monthly allowance or benefit paid to the individual.8938

       (C) All medical reports and recommendations under sections8939
3307.62, 3307.64, and 3307.66 of the Revised Code are privileged,8940
except that copies of such medical reports or recommendations8941
shall be made available to the personal physician, attorney, or8942
authorized agent of the individual concerned upon written release8943
received from the individual or the individual's agent, or, when8944
necessary for the proper administration of the fund, to the board8945
assigned physician.8946

       (D) Any person who is a member or contributor of the system8947
shall be furnished, on written request, with a statement of the8948
amount to the credit of the person's account. The board need not8949
answer more than one request of a person in any one year.8950

       (E) Notwithstanding the exceptions to public inspection in8951
division (B) of this section, the board may furnish the following8952
information:8953

       (1) If a member, former member, retirant, contributor, or8954
former contributor is subject to an order issued under section8955
2907.15 of the Revised Code or an order issued under division (A) 8956
or (B) of section 2929.192 of the Revised Code or is convicted of 8957
or pleads guilty to a violation of section 2921.41 of the Revised 8958
Code, on written request of a prosecutor as defined in section 8959
2935.01 of the Revised Code, the board shall furnish to the 8960
prosecutor the information requested from the individual's 8961
personal history record.8962

       (2) Pursuant to a court or administrative order issued under8963
section 3119.80, 3119.81, 3121.02, 3121.03, or 3123.06 of the8964
Revised Code, the board shall furnish to a court or child support8965
enforcement agency the information required under that section.8966

       (3) At the written request of any person, the board shall8967
provide to the person a list of the names and addresses of8968
members, former members, retirants, contributors, former8969
contributors, or beneficiaries. The costs of compiling, copying,8970
and mailing the list shall be paid by such person.8971

       (4) Within fourteen days after receiving from the director of 8972
job and family services a list of the names and social security8973
numbers of recipients of public assistance pursuant to section8974
5101.181 of the Revised Code or a list of the names and social 8975
security numbers of public medical assistance program recipients 8976
pursuant to section 5160.43 of the Revised Code, the board shall 8977
inform the auditor of state of the name, current or most recent 8978
employer address, and social security number of each member whose 8979
name and social security number are the same as that of a person 8980
whose name or social security number was submitted by the director8981
is included on the list. The board and its employees shall, except 8982
for purposes of furnishing the auditor of state with information 8983
required by this section, preserve the confidentiality of 8984
recipients of public assistance in compliance with division (A) of8985
section 5101.181 of the Revised Code and preserve the 8986
confidentiality of public medical assistance recipients in 8987
compliance with section 5160.43 of the Revised Code.8988

       (5) The system shall comply with orders issued under section8989
3105.87 of the Revised Code.8990

       On the written request of an alternate payee, as defined in8991
section 3105.80 of the Revised Code, the system shall furnish to8992
the alternate payee information on the amount and status of any8993
amounts payable to the alternate payee under an order issued under8994
section 3105.171 or 3105.65 of the Revised Code.8995

       (6) At the request of any person, the board shall make 8996
available to the person copies of all documents, including 8997
resumes, in the board's possession regarding filling a vacancy of 8998
a contributing member or retired teacher member of the board. The 8999
person who made the request shall pay the cost of compiling, 9000
copying, and mailing the documents. The information described in 9001
this division is a public record.9002

       (F) A statement that contains information obtained from the9003
system's records that is signed by an officer of the retirement9004
system and to which the system's official seal is affixed, or9005
copies of the system's records to which the signature and seal are9006
attached, shall be received as true copies of the system's records9007
in any court or before any officer of this state.9008

       Sec. 3309.22.  (A)(1) As used in this division, "personal9009
history record" means information maintained by the board on an9010
individual who is a member, former member, contributor, former9011
contributor, retirant, or beneficiary that includes the address,9012
telephone number, social security number, record of contributions,9013
correspondence with the system, and other information the board9014
determines to be confidential.9015

       (2) The records of the board shall be open to public9016
inspection, except for the following, which shall be excluded,9017
except with the written authorization of the individual concerned:9018

       (a) The individual's statement of previous service and other9019
information as provided for in section 3309.28 of the Revised9020
Code;9021

       (b) Any information identifying by name and address the9022
amount of a monthly allowance or benefit paid to the individual;9023

       (c) The individual's personal history record.9024

       (B) All medical reports and recommendations required by the9025
system are privileged except that copies of such medical reports9026
or recommendations shall be made available to the personal9027
physician, attorney, or authorized agent of the individual9028
concerned upon written release received from the individual or the9029
individual's agent, or when necessary for the proper9030
administration of the fund, to the board assigned physician.9031

       (C) Any person who is a contributor of the system shall be9032
furnished, on written request, with a statement of the amount to9033
the credit of the person's account. The board need not answer more 9034
than one such request of a person in any one year.9035

       (D) Notwithstanding the exceptions to public inspection in9036
division (A)(2) of this section, the board may furnish the9037
following information:9038

       (1) If a member, former member, contributor, former9039
contributor, or retirant is subject to an order issued under9040
section 2907.15 of the Revised Code or an order issued under 9041
division (A) or (B) of section 2929.192 of the Revised Code or is 9042
convicted of or pleads guilty to a violation of section 2921.41 of 9043
the Revised Code, on written request of a prosecutor as defined in 9044
section 2935.01 of the Revised Code, the board shall furnish to 9045
the prosecutor the information requested from the individual's 9046
personal history record.9047

       (2) Pursuant to a court or administrative order issued under9048
section 3119.80, 3119.81, 3121.02, 3121.03, or 3123.06 of the9049
Revised Code, the board shall furnish to a court or child support9050
enforcement agency the information required under that section.9051

       (3) At the written request of any person, the board shall9052
provide to the person a list of the names and addresses of9053
members, former members, retirants, contributors, former9054
contributors, or beneficiaries. The costs of compiling, copying,9055
and mailing the list shall be paid by such person.9056

       (4) Within fourteen days after receiving from the director of 9057
job and family services a list of the names and social security9058
numbers of recipients of public assistance pursuant to section9059
5101.181 of the Revised Code or a list of the names and social 9060
security numbers of public medical assistance program recipients 9061
pursuant to section 5160.43 of the Revised Code, the board shall 9062
inform the auditor of state of the name, current or most recent 9063
employer address, and social security number of each contributor 9064
whose name and social security number are the same as that of a 9065
person whose name or social security number was submitted by the 9066
directoris included on the list. The board and its employees 9067
shall, except for purposes of furnishing the auditor of state with 9068
information required by this section, preserve the confidentiality 9069
of recipients of public assistance in compliance with division (A) 9070
of section 5101.181 of the Revised Code and preserve the 9071
confidentiality of public medical assistance program recipients in 9072
compliance with section 5160.43 of the Revised Code.9073

       (5) The system shall comply with orders issued under section9074
3105.87 of the Revised Code.9075

       On the written request of an alternate payee, as defined in9076
section 3105.80 of the Revised Code, the system shall furnish to9077
the alternate payee information on the amount and status of any9078
amounts payable to the alternate payee under an order issued under9079
section 3105.171 or 3105.65 of the Revised Code.9080

       (6) At the request of any person, the board shall make 9081
available to the person copies of all documents, including 9082
resumes, in the board's possession regarding filling a vacancy of 9083
an employee member or retirant member of the board. The person who 9084
made the request shall pay the cost of compiling, copying, and 9085
mailing the documents. The information described in this division 9086
is a public record.9087

       (E) A statement that contains information obtained from the9088
system's records that is signed by an officer of the retirement9089
system and to which the system's official seal is affixed, or9090
copies of the system's records to which the signature and seal are9091
attached, shall be received as true copies of the system's records9092
in any court or before any officer of this state.9093

       Sec. 3313.714.  (A) As used in this section:9094

       (1) "Board of education" means the board of education of a9095
city, local, exempted village, or joint vocational school9096
district.9097

       (2) "Healthcheck" means the early and periodic screening,9098
diagnosis, and treatment program, a component of the medical9099
assistancemedicaid program established under Title XIX of the9100
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 302, as 9101
amended, and Chapter 5111. of the Revised Code.9102

       (3) "Pupil" means a person under age twenty-two enrolled in9103
the schools of a city, local, exempted village, or joint9104
vocational school district.9105

       (4) "Parent" means either parent with the following9106
exceptions:9107

       (a) If one parent has custody by court order, "parent" means9108
the parent with custody.9109

       (b) If neither parent has legal custody, "parent" means the9110
person or government entity with legal custody.9111

       (c) The child's legal guardian or a person who has accepted9112
responsibility for the health, safety, and welfare of the child.9113

       (B) At the request of the department of job and family9114
serviceshealth care administration, a board of education shall 9115
establish and conduct a healthcheck program for pupils enrolled in 9116
the schools of the district who are medicaid recipients of medical 9117
assistance under Chapter 5111. of the Revised Code. At the request 9118
of a board of education, the department may authorize the board to9119
establish a healthcheck program. A board that establishes a9120
healthcheck program shall enter into a medical assistancemedicaid9121
provider agreement with the department.9122

       A healthcheck program established by a board of education9123
shall be conducted in accordance with rules adopted by the9124
director of job and family serviceshealth care administration9125
under division (F) of this section. The healthcheck program shall 9126
include all of the following components:9127

       (1) A comprehensive health and development history;9128

       (2) A comprehensive physical examination;9129

       (3) A developmental assessment;9130

       (4) A nutritional assessment;9131

       (5) A vision assessment;9132

       (6) A hearing assessment;9133

       (7) An immunization assessment;9134

       (8) Lead screening and laboratory tests ordered by a doctor9135
of medicine or osteopathic medicine as part of one of the other9136
components;9137

       (9) Such other assessment as may be required by the9138
department of job and family serviceshealth care administration9139
in accordance with the requirements of the healthcheck program.9140

       All services included in a board of education's healthcheck9141
program that the board provided under sections 3313.67, 3313.673,9142
3313.68, 3313.69, and 3313.71 of the Revised Code during the9143
1990-1991 school year shall continue to be provided to medical9144
assistancemedicaid recipients by the board pursuant to those 9145
sections. The services shall be considered part of the healthcheck 9146
program for medicaid recipients of medical assistance, and the 9147
board shall be eligible for reimbursement from the state9148
department in accordance with this division for providing the 9149
services.9150

       The department shall reimburse boards of education for9151
healthcheck program services provided under this division at the9152
rates paid under the medical assistancemedicaid program to9153
physicians, dentists, nurses, and other providers of healthcheck9154
services.9155

       (C) Each board of education that conducts a healthcheck9156
program shall determine for each pupil enrolled in the schools of9157
the district whether the pupil is a medical assistancemedicaid9158
recipient. The department of job and family serviceshealth care 9159
administration and county departments of humanjob and family9160
services shall assist the board in making these determinations. 9161
Except as necessary to carry out the purposes of this section, all 9162
information received by a board under this division shall be 9163
confidential.9164

       Before the first day of October of each year, each board that9165
conducts a healthcheck program shall send the parent of each pupil9166
who is under age eighteen and a medicaid recipient of medical9167
assistance notice that the pupil will be examined under the9168
district's healthcheck program unless the parent notifies the9169
board that the parent denies consent for the examination. The9170
notice shall include a form to be used by the parent to indicate 9171
that the parent denies consent. The denial shall be effective only 9172
if the form is signed by the parent and returned to the board or 9173
the school in which the pupil is enrolled. If the parent does not9174
return a signed form indicating denial of consent within two weeks9175
after the date the notice is sent, the school district and the9176
department of job and family serviceshealth care administration9177
shall deem the parent to have consented to examination of the 9178
parent's child under the healthcheck program. In the case of a 9179
pupil age eighteen or older, the notice shall be given to the 9180
pupil, and the school district and the department of job and 9181
family services shall deem the pupil to have consented to 9182
examination unless the pupil returns the signed form indicating 9183
the pupil's denial of consent.9184

       (D)(1) As used in this division:9185

       (a) "Nonfederal share" means the portion of expenditures for9186
services that is required under the medical assistancemedicaid9187
program to be paid for with state or local government funds.9188

       (b) "Federal financial participation" means the portion of9189
expenditures for services that is reimbursed under the medical9190
assistancemedicaid program with federal funds.9191

       (2) At the request of a board of education, the state9192
department may enter into an agreement with board under which the9193
board provides medical services to a medicaid recipient of medical9194
assistance that are reimbursable under the medical assistance9195
medicaid program but not under the healthcheck program. The 9196
agreement may be for a term specified in the agreement and 9197
renewable by mutual consent of the board and the department, or 9198
may continue in force as long as agreeable to the board and the 9199
department.9200

       The board shall use state or local funds of the district to9201
pay the nonfederal share of expenditures for services provided9202
under this division. Prior to entering into or renewing an9203
agreement and at any other time requested by the department while9204
the agreement is in force, the board shall certify to the9205
department in accordance with the rules adopted under division (F)9206
of this section that it will have sufficient state or local funds9207
to pay the nonfederal share of expenditures under this division.9208
If the board fails to make the certification, the department shall9209
not enter into or renew the agreement. If an agreement has been9210
entered into, it shall be void unless the board makes the9211
certification not later than fifteen days after receiving notice9212
from the department that the certification is due. The board shall 9213
report to the department, in accordance with the rules, the amount 9214
of state or local funds it spends to provide services under this 9215
division.9216

       The department shall reimburse the board the federal9217
financial participation allowed for the board's expenditures for9218
services under this division. The total of the nonfederal share9219
spent by the board and the federal financial participation9220
reimbursed by the department for a service rendered under this9221
division shall be an amount agreed to by the board and the9222
department, but shall not exceed the maximum reimbursable for that9223
service under rules adopted by the director of job and family9224
serviceshealth care administration under Chapter 5111.section 9225
5163.15 of the Revised Code. The rules adopted under division (F) 9226
of this section shall include procedures under which the 9227
department will recover from a board overpayments and subsequent 9228
federal audit disallowances of federal financial participation 9229
reimbursed by the department.9230

       (E) A board of education shall provide services under9231
division (D) of this section and under its healthcheck program as9232
provided in division (E)(1), (2), or (3) of this section:9233

       (1) By having the services performed by physicians, dentists, 9234
and nurses employed by the board;9235

       (2) By contracting with physicians, dentists, nurses, and9236
other providers of services who have medical assistancemedicaid9237
provider agreements with the department of job and family services9238
health care administration;9239

       (3) By having some of the services performed by persons9240
described in division (E)(1) of this section and others performed9241
by persons described in division (E)(2) of this section.9242

       (F) The director of job and family serviceshealth care 9243
administration shall adopt rules in accordance with Chapter 119. 9244
of the Revised Code governing healthcheck programs conducted under 9245
this section and services provided under division (D) of this 9246
section.9247

       Sec. 3313.715.  The board of education of a school district9248
may request from the director of mental retardation and9249
developmental disabilities the appropriate identification numbers9250
for all students residing in the district who are medical9251
assistancemedicaid recipients under Chapter 5111. of the Revised 9252
Code. The director shall furnish such numbers upon receipt of 9253
lists of student names furnished by the district board, in such 9254
form as the director may require.9255

       The director of job and family serviceshealth care 9256
administration shall provide the director of mental retardation 9257
and developmental disabilities with the data necessary for 9258
compliance with this section.9259

       Section 3319.321 of the Revised Code does not apply to the9260
release of student names or other data to the director of mental9261
retardation and developmental disabilities for the purposes of9262
this section. Chapter 1347. of the Revised Code does not apply to9263
information required to be kept by a school board or the9264
departments of job and family serviceshealth care administration9265
or mental retardation and developmental disabilities to the extent 9266
necessary to comply with this section and section 3313.714 of the 9267
Revised Code. However, any such information or data shall be used 9268
only for the specific legal purposes of such boards and 9269
departments and shall not be released to any unauthorized person.9270

       Sec. 3323.021.  As used in this section, "participating9271
county MR/DD board" means a county board of mental retardation and9272
developmental disabilities electing to participate in the9273
provision of or contracting for educational services for children9274
under division (D) of section 5126.05 of the Revised Code.9275

       (A) When a school district, educational service center, or9276
participating county MR/DD board enters into an agreement or9277
contract with another school district, educational service center,9278
or participating county MR/DD board to provide educational9279
services to a disabled child during a school year, both of the9280
following shall apply:9281

       (1) Beginning with fiscal year 1999, if the provider of the9282
services intends to increase the amount it charges for some or all9283
of those services during the next school year or if the provider9284
intends to cease offering all or part of those services during the9285
next school year, the provider shall notify the entity for which9286
the services are provided of these intended changes no later that9287
than the first day of March of the current fiscal year.9288

       (2) Beginning with fiscal year 1999, if the entity for which9289
services are provided intends to cease obtaining those services9290
from the provider for the next school year or intends to change9291
the type or amount of services it obtains from the provider for9292
the next school year, the entity shall notify the service provider9293
of these intended changes no later than the first day of March of9294
the current fiscal year.9295

       (B) School districts, educational service centers,9296
participating county MR/DD boards, and other applicable9297
governmental entities shall collaborate where possible to maximize9298
federal sources of revenue to provide additional funds for special 9299
education related services for disabled children. Annually, each 9300
school district shall report to the department of education any 9301
amounts of money the district received through such medical9302
assistancethe medicaid program.9303

       (C) The state board of education, the department of mental9304
retardation and developmental disabilities, and the department of9305
job and family serviceshealth care administration shall develop 9306
working agreements for pursuing additional funds for services for 9307
disabled children.9308

       Sec. 3599.45.  (A) No candidate for the office of attorney9309
general or county prosecutor or such a candidate's campaign9310
committee shall knowingly accept any contribution from a provider9311
of services or goods under contract with the department of job and9312
family serviceshealth care administration pursuant to the 9313
medicaid program of Title XIX of the "Social Security Act," 49 9314
Stat. 620 (1935), 42 U.S.C. 301, as amended, or from any person 9315
having an ownership interest in the provider.9316

       As used in this section "candidate," "campaign committee,"9317
and "contribution" have the same meaning as in section 3517.01 of9318
the Revised Code.9319

       (B) Whoever violates this section is guilty of a misdemeanor9320
of the first degree.9321

       Sec. 3701.023.  (A) The department of health shall review9322
applications for eligibility for the program for medically9323
handicapped children that are submitted to the department by city9324
and general health districts and physician providers approved in9325
accordance with division (C) of this section. The department shall 9326
determine whether the applicants meet the medical and financial 9327
eligibility requirements established by the public health council 9328
pursuant to division (A)(1) of section 3701.021 of the Revised 9329
Code, and by the department in the manual of operational 9330
procedures and guidelines for the program for medically 9331
handicapped children developed pursuant to division (B) of that 9332
section. Referrals of potentially eligible children for the 9333
program may be submitted to the department on behalf of the child 9334
by parents, guardians, public health nurses, or any other9335
interested person. The department of health may designate other9336
agencies to refer applicants to the department of health.9337

       (B) In accordance with the procedures established in rules9338
adopted under division (A)(4) of section 3701.021 of the Revised9339
Code, the department of health shall authorize a provider or9340
providers to provide to any Ohio resident under twenty-one years9341
of age, without charge to the resident or the resident's family9342
and without restriction as to the economic status of the resident9343
or the resident's family, diagnostic services necessary to9344
determine whether the resident has a medically handicapping or 9345
potentially medically handicapping condition.9346

       (C) The department of health shall review the applications of 9347
health professionals, hospitals, medical equipment suppliers, and 9348
other individuals, groups, or agencies that apply to become9349
providers. The department shall enter into a written agreement9350
with each applicant who is determined, pursuant to the9351
requirements set forth in rules adopted under division (A)(2) of9352
section 3701.021 of the Revised Code, to be eligible to be a9353
provider in accordance with the provider agreement required by the9354
medical assistancemedicaid program established under section 9355
5111.01 of the Revised Code. No provider shall charge a medically9356
handicapped child or the child's parent or guardian for services9357
authorized by the department under division (B) or (D) of this9358
section.9359

       The department, in accordance with rules adopted under9360
division (A)(3) of section 3701.021 of the Revised Code, may9361
disqualify any provider from further participation in the program9362
for violating any requirement set forth in rules adopted under9363
division (A)(2) of that section. The disqualification shall not9364
take effect until a written notice, specifying the requirement9365
violated and describing the nature of the violation, has been9366
delivered to the provider and the department has afforded the9367
provider an opportunity to appeal the disqualification under9368
division (H) of this section.9369

       (D) The department of health shall evaluate applications from 9370
city and general health districts and approved physician providers 9371
for authorization to provide treatment services, service9372
coordination, and related goods to children determined to be9373
eligible for the program for medically handicapped children9374
pursuant to division (A) of this section. The department shall9375
authorize necessary treatment services, service coordination, and9376
related goods for each eligible child in accordance with an9377
individual plan of treatment for the child. As an alternative, the 9378
department may authorize payment of health insurance premiums on 9379
behalf of eligible children when the department determines, in9380
accordance with criteria set forth in rules adopted under division9381
(A)(9) of section 3701.021 of the Revised Code, that payment of9382
the premiums is cost-effective.9383

       (E) The department of health shall pay, from appropriations9384
to the department, any necessary expenses, including but not9385
limited to, expenses for diagnosis, treatment, service9386
coordination, supportive services, transportation, and accessories9387
and their upkeep, provided to medically handicapped children,9388
provided that the provision of the goods or services is authorized9389
by the department under division (B) or (D) of this section. Money9390
appropriated to the department of health may also be expended for9391
reasonable administrative costs incurred by the program. The9392
department of health also may purchase liability insurance9393
covering the provision of services under the program for medically9394
handicapped children by physicians and other health care9395
professionals.9396

       Payments made to providers by the department of health 9397
pursuant to this division for inpatient hospital care, outpatient 9398
care, and all other medical assistance furnished to eligible9399
recipients shall be made in accordance with rules adopted by the 9400
public health council pursuant to division (A) of section 3701.021 9401
of the Revised Code.9402

       The departments of health and job and family serviceshealth 9403
care administration shall jointly implement procedures to ensure 9404
that duplicate payments are not made under the program for 9405
medically handicapped children and the medical assistancemedicaid9406
program established under section 5111.01 of the Revised Code and 9407
to identify and recover duplicate payments.9408

       (F) At the time of applying for participation in the program 9409
for medically handicapped children, a medically handicapped child 9410
or the child's parent or guardian shall disclose the identity of 9411
any third party against whom the child or the child's parent or 9412
guardian has or may have a right of recovery for goods and9413
services provided under division (B) or (D) of this section. The9414
department of health shall require a medically handicapped child9415
who receives services from the program or the child's parent or 9416
guardian to apply for all third-party benefits for which the child 9417
may be eligible and require the child, parent, or guardian to 9418
apply all third-party benefits received to the amount determined 9419
under division (E) of this section as the amount payable for goods 9420
and services authorized under division (B) or (D) of this section.9421
The department is the payer of last resort and shall pay for9422
authorized goods or services, up to the amount determined under9423
division (E) of this section for the authorized goods or services, 9424
only to the extent that payment for the authorized goods or 9425
services is not made through third-party benefits. When a third 9426
party fails to act on an application or claim for benefits by a 9427
medically handicapped child or the child's parent or guardian, the 9428
department shall pay for the goods or services only after ninety 9429
days have elapsed since the date the child, parents, or guardians 9430
made an application or claim for all third-party benefits.9431
Third-party benefits received shall be applied to the amount9432
determined under division (E) of this section. Third-party9433
payments for goods and services not authorized under division (B)9434
or (D) of this section shall not be applied to payment amounts9435
determined under division (E) of this section. Payment made by the 9436
department shall be considered payment in full of the amount9437
determined under division (E) of this section. Medicaid payments9438
for persons eligible for the medical assistancemedicaid program9439
established under section 5111.01 of the Revised Code shall be9440
considered payment in full of the amount determined under division 9441
(E) of this section.9442

       (G) The department of health shall administer a program to9443
provide services to Ohio residents who are twenty-one or more9444
years of age who have cystic fibrosis and who meet the eligibility 9445
requirements established by the rules of the public health council 9446
pursuant to division (A)(7) of section 3701.021 of the Revised 9447
Code, subject to all provisions of this section, but not subject 9448
to section 3701.024 of the Revised Code.9449

       (H) The department of health shall provide for appeals, in9450
accordance with rules adopted under section 3701.021 of the9451
Revised Code, of denials of applications for the program for9452
medically handicapped children under division (A) or (D) of this9453
section, disqualification of providers, or amounts paid under9454
division (E) of this section. Appeals under this division are not9455
subject to Chapter 119. of the Revised Code.9456

       The department may designate ombudspersons to assist9457
medically handicapped children or their parents or guardians, upon9458
the request of the children, parents, or guardians, in filing9459
appeals under this division and to serve as children's, parents',9460
or guardians' advocates in matters pertaining to the9461
administration of the program for medically handicapped children9462
and eligibility for program services. The ombudspersons shall9463
receive no compensation but shall be reimbursed by the department,9464
in accordance with rules of the office of budget and management,9465
for their actual and necessary travel expenses incurred in the9466
performance of their duties.9467

       (I) The department of health, and city and general health9468
districts providing service coordination pursuant to division9469
(A)(2) of section 3701.024 of the Revised Code, shall provide9470
service coordination in accordance with the standards set forth in9471
the rules adopted under section 3701.021 of the Revised Code,9472
without charge, and without restriction as to economic status.9473

       Sec. 3701.024.  (A)(1) Under a procedure established in rules 9474
adopted under section 3701.021 of the Revised Code, the department 9475
of health shall determine the amount each county shall provide 9476
annually for the program for medically handicapped children, based 9477
on a proportion of the county's total general property tax 9478
duplicate, not to exceed one-tenth of a mill, and charge the 9479
county for any part of expenses incurred under the program for 9480
treatment services on behalf of medically handicapped children 9481
having legal settlement in the county that is not paid from 9482
federal funds or through the medical assistancemedicaid program9483
established under section 5111.01 of the Revised Code. The9484
department shall not charge the county for expenses exceeding the9485
difference between the amount determined under division (A)(1) of9486
this section and any amounts retained under divisions (A)(2) and9487
(3) of this section.9488

       All amounts collected by the department under division (A)(1) 9489
of this section shall be deposited into the state treasury to the 9490
credit of the medically handicapped children-county assessment 9491
fund, which is hereby created. The fund shall be used by the 9492
department to comply with sections 3701.021 to 3701.028 of the 9493
Revised Code.9494

       (2) The department, in accordance with rules adopted under9495
section 3701.021 of the Revised Code, may allow each county to9496
retain up to ten per cent of the amount determined under division9497
(A)(1) of this section to provide funds to city or general health9498
districts of the county with which the districts shall provide9499
service coordination, public health nursing, or transportation9500
services for medically handicapped children.9501

       (3) In addition to any amount retained under division (A)(2) 9502
of this section, the department, in accordance with rules adopted 9503
under section 3701.021 of the Revised Code, may allow counties 9504
that it determines have significant numbers of potentially 9505
eligible medically handicapped children to retain an amount equal 9506
to the difference between:9507

       (a) Twenty-five per cent of the amount determined under9508
division (A)(1) of this section;9509

       (b) Any amount retained under division (A)(2) of this9510
section.9511

       Counties shall use amounts retained under division (A)(3) of 9512
this section to provide funds to city or general health districts 9513
of the county with which the districts shall conduct outreach 9514
activities to increase participation in the program for medically 9515
handicapped children.9516

       (4) Prior to any increase in the millage charged to a county, 9517
the public health council shall hold a public hearing on the 9518
proposed increase and shall give notice of the hearing to each 9519
board of county commissioners that would be affected by the9520
increase at least thirty days prior to the date set for the9521
hearing. Any county commissioner may appear and give testimony at 9522
the hearing. Any increase in the millage any county is required to 9523
provide for the program for medically handicapped children shall 9524
be determined, and notice of the amount of the increase shall be 9525
provided to each affected board of county commissioners, no later 9526
than the first day of June of the fiscal year next preceding the 9527
fiscal year in which the increase will take effect.9528

       (B) Each board of county commissioners shall establish a9529
medically handicapped children's fund and shall appropriate9530
thereto an amount, determined in accordance with division (A)(1)9531
of this section, for the county's share in providing medical,9532
surgical, and other aid to medically handicapped children residing 9533
in such county and for the purposes specified in divisions (A)(2) 9534
and (3) of this section. Each county shall use money retained 9535
under divisions (A)(2) and (3) of this section only for the 9536
purposes specified in those divisions.9537

       Sec. 3701.027.  The department of health shall administer9538
funds received from the "Maternal and Child Health Block Grant,"9539
Title V of the "Social Security Act," 95 Stat. 818 (1981), 429540
U.S.C.A. 701, as amended, for programs including the program for9541
medically handicapped children, and to provide technical9542
assistance and consultation to city and general health districts9543
and local health planning organizations in implementing local,9544
community-based, family-centered, coordinated systems of care for9545
medically handicapped children. The department may make grants to 9546
persons and other entities for the provision of services with the 9547
funds. In addition, the department may use the funds to purchase 9548
liability insurance covering the provision of services under the 9549
programs by physicians and other health care professionals, and to 9550
pay health insurance premiums on behalf of medically handicapped 9551
children participating in the program for medically handicapped 9552
children when the department determines, in accordance with 9553
criteria set forth in rules adopted under division (A)(9) of 9554
section 3701.021 of the Revised Code, that payment of the premiums 9555
is cost effective.9556

       In determining eligibility for services provided with funds9557
received from the "Maternal and Child Health Block Grant," the9558
department may use the application form established under section9559
5111.0135162.15 of the Revised Code. The department may require9560
applicants to furnish their social security numbers.9561

       Sec. 3701.043.  If authorized by federal statute or9562
regulation, the director of health may establish and collect fees 9563
for conducting the initial certification of any person or entity 9564
as a provider of health services for purposes of the medicare 9565
program established under Title XVIII of the Social Security Act, 9566
49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended. The fee 9567
established for conducting an initial medicare certification shall 9568
not exceed the actual and necessary costs incurred by the9569
department of health in conducting the certification.9570

       All fees collected under this section shall be deposited into 9571
the state treasury to the credit of the medicare initial 9572
certification fund, which is hereby created. Money credited to the 9573
fund shall be used solely to pay the costs of conducting initial 9574
medicare certifications.9575

       Sec. 3701.132.  The department of health is hereby designated 9576
as the state agency to administer the "special supplemental 9577
nutrition program for women, infants, and children" established 9578
under the "Child Nutrition Act of 1966," 80 Stat. 885, 42 U.S.C. 9579
1786, as amended. The public health council may adopt rules 9580
pursuant to Chapter 119. of the Revised Code as necessary for9581
administering the program. The rules may include civil money 9582
penalties for violations of the rules.9583

       In determining eligibility for services provided under the 9584
program, the department may use the application form established 9585
under section 5111.0135162.15 of the Revised Code for the healthy 9586
start program. The department may require applicants to furnish 9587
their social security numbers.9588

       If the department determines that a vendor has committed an 9589
act with respect to the program that federal statutes or 9590
regulations or state statutes or rules prohibit, the department 9591
shall take action against the vendor in the manner required by 7 9592
C.F.R. part 246, including imposition of a civil money penalty in 9593
accordance with 7 C.F.R. 246.12, or rules adopted under this 9594
section.9595

       Sec. 3701.243.  (A) Except as provided in this section or9596
section 3701.248 of the Revised Code, no person or agency of state 9597
or local government that acquires the information while providing 9598
any health care service or while in the employ of a health care 9599
facility or health care provider shall disclose or compel another 9600
to disclose any of the following:9601

       (1) The identity of any individual on whom an HIV test is9602
performed;9603

       (2) The results of an HIV test in a form that identifies the 9604
individual tested;9605

       (3) The identity of any individual diagnosed as having AIDS 9606
or an AIDS-related condition.9607

       (B)(1) Except as provided in divisions (B)(2), (C), (D), and 9608
(F) of this section, the results of an HIV test or the identity of 9609
an individual on whom an HIV test is performed or who is diagnosed 9610
as having AIDS or an AIDS-related condition may be disclosed only 9611
to the following:9612

       (a) The individual who was tested or the individual's legal 9613
guardian, and the individual's spouse or any sexual partner;9614

       (b) A person to whom disclosure is authorized by a written9615
release, executed by the individual tested or by the individual's 9616
legal guardian and specifying to whom disclosure of the test9617
results or diagnosis is authorized and the time period during 9618
which the release is to be effective;9619

       (c) The individual's physician;9620

       (d) The department of health or a health commissioner to9621
which reports are made under section 3701.24 of the Revised Code;9622

       (e) A health care facility or provider that procures,9623
processes, distributes, or uses a human body part from a deceased9624
individual, donated for a purpose specified in Chapter 2108. of9625
the Revised Code, and that needs medical information about the9626
deceased individual to ensure that the body part is medically9627
acceptable for its intended purpose;9628

       (f) Health care facility staff committees or accreditation or 9629
oversight review organizations conducting program monitoring,9630
program evaluation, or service reviews;9631

       (g) A health care provider, emergency medical services9632
worker, or peace officer who sustained a significant exposure to9633
the body fluids of another individual, if that individual was9634
tested pursuant to division (E)(6) of section 3701.242 of the9635
Revised Code, except that the identity of the individual tested9636
shall not be revealed;9637

       (h) To law enforcement authorities pursuant to a search9638
warrant or a subpoena issued by or at the request of a grand jury, 9639
a prosecuting attorney, a city director of law or similar chief 9640
legal officer of a municipal corporation, or a village solicitor, 9641
in connection with a criminal investigation or prosecution.9642

       (2) The results of an HIV test or a diagnosis of AIDS or an 9643
AIDS-related condition may be disclosed to a health care provider, 9644
or an authorized agent or employee of a health care facility or a 9645
health care provider, if the provider, agent, or employee has a 9646
medical need to know the information and is participating in the 9647
diagnosis, care, or treatment of the individual on whom the test 9648
was performed or who has been diagnosed as having AIDS or an 9649
AIDS-related condition.9650

       This division does not impose a standard of disclosure9651
different from the standard for disclosure of all other specific9652
information about a patient to health care providers and9653
facilities. Disclosure may not be requested or made solely for the 9654
purpose of identifying an individual who has a positive HIV test 9655
result or has been diagnosed as having AIDS or an AIDS-related 9656
condition in order to refuse to treat the individual. Referral of 9657
an individual to another health care provider or facility based on 9658
reasonable professional judgment does not constitute refusal to 9659
treat the individual.9660

       (3) Not later than ninety days after November 1, 1989, each 9661
health care facility in this state shall establish a protocol to 9662
be followed by employees and individuals affiliated with the 9663
facility in making disclosures authorized by division (B)(2) of 9664
this section. A person employed by or affiliated with a health 9665
care facility who determines in accordance with the protocol 9666
established by the facility that a disclosure is authorized by 9667
division (B)(2) of this section is immune from liability to any 9668
person in a civil action for damages for injury, death, or loss to 9669
person or property resulting from the disclosure.9670

       (C)(1) Any person or government agency may seek access to or 9671
authority to disclose the HIV test records of an individual in9672
accordance with the following provisions:9673

       (a) The person or government agency shall bring an action in 9674
a court of common pleas requesting disclosure of or authority to 9675
disclose the results of an HIV test of a specific individual, who 9676
shall be identified in the complaint by a pseudonym but whose name 9677
shall be communicated to the court confidentially, pursuant to a 9678
court order restricting the use of the name. The court shall 9679
provide the individual with notice and an opportunity to9680
participate in the proceedings if the individual is not named as a 9681
party. Proceedings shall be conducted in chambers unless the 9682
individual agrees to a hearing in open court.9683

       (b) The court may issue an order granting the plaintiff9684
access to or authority to disclose the test results only if the9685
court finds by clear and convincing evidence that the plaintiff9686
has demonstrated a compelling need for disclosure of the9687
information that cannot be accommodated by other means. In9688
assessing compelling need, the court shall weigh the need for9689
disclosure against the privacy right of the individual tested and9690
against any disservice to the public interest that might result9691
from the disclosure, such as discrimination against the individual 9692
or the deterrence of others from being tested.9693

       (c) If the court issues an order, it shall guard against9694
unauthorized disclosure by specifying the persons who may have9695
access to the information, the purposes for which the information9696
shall be used, and prohibitions against future disclosure.9697

       (2) A person or government agency that considers it necessary 9698
to disclose the results of an HIV test of a specific individual in 9699
an action in which it is a party may seek authority for the 9700
disclosure by filing an in camera motion with the court in which 9701
the action is being heard. In hearing the motion, the court shall 9702
employ procedures for confidentiality similar to those specified 9703
in division (C)(1) of this section. The court shall grant the 9704
motion only if it finds by clear and convincing evidence that a 9705
compelling need for the disclosure has been demonstrated.9706

       (3) Except for an order issued in a criminal prosecution or 9707
an order under division (C)(1) or (2) of this section granting9708
disclosure of the result of an HIV test of a specific individual,9709
a court shall not compel a blood bank, hospital blood center, or9710
blood collection facility to disclose the result of HIV tests9711
performed on the blood of voluntary donors in a way that reveals9712
the identity of any donor.9713

       (4) In a civil action in which the plaintiff seeks to recover 9714
damages from an individual defendant based on an allegation that 9715
the plaintiff contracted the HIV virus as a result of actions of 9716
the defendant, the prohibitions against disclosure in this section 9717
do not bar discovery of the results of any HIV test given to the 9718
defendant or any diagnosis that the defendant suffers from AIDS or 9719
an AIDS-related condition.9720

       (D) The results of an HIV test or the identity of an9721
individual on whom an HIV test is performed or who is diagnosed as 9722
having AIDS or an AIDS-related condition may be disclosed to a 9723
federal, state, or local government agency, or the official9724
representative of such an agency, for purposes of the medical9725
assistancemedicaid program established under section 5111.01 of 9726
the Revised Code, the medicare program established under Title 9727
XVIII of the "Social Security Act," 49 Stat. 620 (1935) 42 9728
U.S.C.A. 301, as amended, or any other public assistance program.9729

       (E) Any disclosure pursuant to this section shall be in9730
writing and accompanied by a written statement that includes the9731
following or substantially similar language: "This information has 9732
been disclosed to you from confidential records protected from 9733
disclosure by state law. You shall make no further disclosure of 9734
this information without the specific, written, and informed 9735
release of the individual to whom it pertains, or as otherwise 9736
permitted by state law. A general authorization for the release of 9737
medical or other information is not sufficient for the purpose of 9738
the release of HIV test results or diagnoses."9739

       (F) An individual who knows that the individual has received 9740
a positive result on an HIV test or has been diagnosed as having9741
AIDS or an AIDS-related condition shall disclose this information 9742
to any other person with whom the individual intends to make 9743
common use of a hypodermic needle or engage in sexual conduct as 9744
defined in section 2907.01 of the Revised Code. An individual's 9745
compliance with this division does not prohibit a prosecution of 9746
the individual for a violation of division (B) of section 2903.11 9747
of the Revised Code.9748

       (G) Nothing in this section prohibits the introduction of9749
evidence concerning an HIV test of a specific individual in a9750
criminal proceeding.9751

       Sec. 3701.507.  (A) To assist in implementing sections9752
3701.503 to 3701.509 of the Revised Code, the medically9753
handicapped children's medical advisory council created in section9754
3701.025 of the Revised Code shall appoint a permanent infant9755
hearing screening subcommittee. The subcommittee shall consist of9756
the following members:9757

       (1) One otolaryngologist;9758

       (2) One neonatologist;9759

       (3) One pediatrician;9760

       (4) One neurologist;9761

       (5) One hospital administrator;9762

       (6) Two or more audiologists who are experienced in infant9763
hearing screening and evaluation;9764

       (7) One speech-language pathologist licensed under section9765
4753.07 of the Revised Code;9766

       (8) Two persons who are each a parent of a hearing-impaired9767
child;9768

       (9) One geneticist;9769

       (10) One epidemiologist;9770

       (11) One adult who is deaf or hearing impaired;9771

       (12) One representative from an organization for the deaf or9772
hearing impaired;9773

       (13) One family advocate;9774

       (14) One nurse from a well-baby neonatal nursery;9775

       (15) One nurse from a special care neonatal nursery;9776

       (16) One teacher of the deaf who works with infants and9777
toddlers;9778

       (17) One representative of the health insurance industry;9779

       (18) One representative of the bureau for children with9780
medical handicaps;9781

       (19) One representative of the department of education;9782

       (20) One representative of the Ohio department of job and9783
family services who has responsibilities regarding medicaidhealth 9784
care administration;9785

       (21) Any other person the advisory council appoints.9786

       (B) The infant hearing subcommittee shall:9787

       (1) Consult with the director of health regarding the9788
administration of sections 3701.503 to 3701.509 of the Revised9789
Code;9790

       (2) Advise and make recommendations regarding proposed rules9791
prior to their adoption by the public health council under section 9792
3701.508 of the Revised Code;9793

       (3) Consult with the director of health and advise and make9794
recommendations regarding program development and implementation9795
under sections 3701.503 to 3701.509 of the Revised Code, including 9796
all of the following:9797

       (a) Establishment under section 3701.504 of the Revised Code9798
of the statewide hearing screening, tracking, and early9799
intervention program to identify newborn and infant hearing9800
impairment;9801

       (b) Identification of locations where hearing evaluations may 9802
be conducted;9803

       (c) Recommendations for methods and techniques of hearing9804
screening and hearing evaluation;9805

       (d) Referral, data recording and compilation, and procedures9806
to encourage follow-up hearing care;9807

       (e) Maintenance of a register of newborns and infants who do9808
not pass the hearing screening;9809

       (f) Preparation of the information required by section9810
3701.506 of the Revised Code and any other information the public9811
health council requires the department of health to provide.9812

       Sec. 3701.74.  (A) As used in this section and section9813
3701.741 of the Revised Code:9814

       (1) "Ambulatory care facility" means a facility that provides9815
medical, diagnostic, or surgical treatment to patients who do not9816
require hospitalization, including a dialysis center, ambulatory9817
surgical facility, cardiac catheterization facility, diagnostic9818
imaging center, extracorporeal shock wave lithotripsy center, home9819
health agency, inpatient hospice, birthing center, radiation9820
therapy center, emergency facility, and an urgent care center.9821
"Ambulatory care facility" does not include the private office of9822
a physician or dentist, whether the office is for an individual or9823
group practice.9824

       (2) "Chiropractor" means an individual licensed under Chapter9825
4734. of the Revised Code to practice chiropractic.9826

       (3) "Emergency facility" means a hospital emergency9827
department or any other facility that provides emergency medical9828
services.9829

       (4) "Health care practitioner" means all of the following:9830

       (a) A dentist or dental hygienist licensed under Chapter9831
4715. of the Revised Code;9832

       (b) A registered or licensed practical nurse licensed under9833
Chapter 4723. of the Revised Code;9834

       (c) An optometrist licensed under Chapter 4725. of the9835
Revised Code;9836

       (d) A dispensing optician, spectacle dispensing optician,9837
contact lens dispensing optician, or spectacle-contact lens9838
dispensing optician licensed under Chapter 4725. of the Revised9839
Code;9840

       (e) A pharmacist licensed under Chapter 4729. of the Revised9841
Code;9842

       (f) A physician;9843

       (g) A physician assistant authorized under Chapter 4730. of9844
the Revised Code to practice as a physician assistant;9845

       (h) A practitioner of a limited branch of medicine issued a9846
certificate under Chapter 4731. of the Revised Code;9847

       (i) A psychologist licensed under Chapter 4732. of the9848
Revised Code;9849

       (j) A chiropractor;9850

       (k) A hearing aid dealer or fitter licensed under Chapter9851
4747. of the Revised Code;9852

       (l) A speech-language pathologist or audiologist licensed9853
under Chapter 4753. of the Revised Code;9854

       (m) An occupational therapist or occupational therapy9855
assistant licensed under Chapter 4755. of the Revised Code;9856

       (n) A physical therapist or physical therapy assistant9857
licensed under Chapter 4755. of the Revised Code;9858

       (o) A professional clinical counselor, professional9859
counselor, social worker, or independent social worker licensed,9860
or a social work assistant registered, under Chapter 4757. of the9861
Revised Code;9862

       (p) A dietitian licensed under Chapter 4759. of the Revised9863
Code;9864

       (q) A respiratory care professional licensed under Chapter9865
4761. of the Revised Code;9866

       (r) An emergency medical technician-basic, emergency medical9867
technician-intermediate, or emergency medical technician-paramedic9868
certified under Chapter 4765. of the Revised Code.9869

       (5) "Health care provider" means a hospital, ambulatory care 9870
facility, long-term care facility, pharmacy, emergency facility, 9871
or health care practitioner.9872

       (6) "Hospital" has the same meaning as in section 3727.01 of9873
the Revised Code.9874

       (7) "Long-term care facility" means a nursing home,9875
residential care facility, or home for the aging, as those terms9876
are defined in section 3721.01 of the Revised Code; an adult care9877
facility, as defined in section 3722.01 of the Revised Code; a9878
nursing facility or intermediate care facility for the mentally9879
retarded, as those terms are defined in section 5111.205164.01 of 9880
the Revised Code; a facility or portion of a facility certified as 9881
a skilled nursing facility under Title XVIII of the "Social9882
Security Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended9883
medicare program.9884

       (8) "Medical record" means data in any form that pertains to 9885
a patient's medical history, diagnosis, prognosis, or medical9886
condition and that is generated and maintained by a health care9887
provider in the process of the patient's health care treatment.9888

       (9) "Medical records company" means a person who stores,9889
locates, or copies medical records for a health care provider, or9890
is compensated for doing so by a health care provider, and charges9891
a fee for providing medical records to a patient or patient's9892
representative.9893

       (10) "Patient" means either of the following:9894

       (a) An individual who received health care treatment from a9895
health care provider;9896

       (b) A guardian, as defined in section 1337.11 of the Revised9897
Code, of an individual described in division (A)(10)(a) of this9898
section.9899

       (11) "Patient's personal representative" means a minor 9900
patient's parent or other person acting in loco parentis, a 9901
court-appointed guardian, or a person with durable power of 9902
attorney for health care for a patient, the executor or 9903
administrator of the patient's estate, or the person responsible9904
for the patient's estate if it is not to be probated. "Patient's 9905
personal representative" does not include an insurer authorized 9906
under Title XXXIX of the Revised Code to do the business of9907
sickness and accident insurance in this state, a health insuring 9908
corporation holding a certificate of authority under Chapter 1751. 9909
of the Revised Code, or any other person not named in this 9910
division.9911

       (12) "Pharmacy" has the same meaning as in section 4729.01 of9912
the Revised Code.9913

       (13) "Physician" means a person authorized under Chapter9914
4731. of the Revised Code to practice medicine and surgery,9915
osteopathic medicine and surgery, or podiatric medicine and 9916
surgery.9917

       (14) "Authorized person" means a person to whom a patient has 9918
given written authorization to act on the patient's behalf 9919
regarding the patient's medical record.9920

       (B) A patient, a patient's personal representative or an 9921
authorized person who wishes to examine or obtain a copy of part 9922
or all of a medical record shall submit to the health care 9923
provider a written request signed by the patient, personal 9924
representative, or authorized person dated not more than one year9925
before the date on which it is submitted. The request shall 9926
indicate whether the copy is to be sent to the requestor,9927
physician or chiropractor, or held for the requestor at the 9928
office of the health care provider. Within a reasonable time after9929
receiving a request that meets the requirements of this division9930
and includes sufficient information to identify the record9931
requested, a health care provider that has the patient's medical 9932
records shall permit the patient to examine the record during 9933
regular business hours without charge or, on request, shall 9934
provide a copy of the record in accordance with section 3701.741 9935
of the Revised Code, except that if a physician or chiropractor 9936
who has treated the patient determines for clearly stated 9937
treatment reasons that disclosure of the requested record is 9938
likely to have an adverse effect on the patient, the health care 9939
provider shall provide the record to a physician or chiropractor 9940
designated by the patient. The health care provider shall take9941
reasonable steps to establish the identity of the person making 9942
the request to examine or obtain a copy of the patient's record.9943

       (C) If a health care provider fails to furnish a medical9944
record as required by division (B) of this section, the patient, 9945
personal representative, or authorized person who requested the9946
record may bring a civil action to enforce the patient's right of9947
access to the record.9948

       (D)(1) This section does not apply to medical records whose9949
release is covered by section 173.20 or 3721.13 of the Revised9950
Code, by Chapter 1347. or 5122. of the Revised Code, by 42 C.F.R.9951
part 2, "Confidentiality of Alcohol and Drug Abuse Patient9952
Records," or by 42 C.F.R. 483.10.9953

       (2) Nothing in this section is intended to supersede the9954
confidentiality provisions of sections 2305.24, 2305.25, 2305.251, 9955
and 2305.252 of the Revised Code.9956

       Sec. 3701.741.  (A) Each health care provider and medical 9957
records company shall provide copies of medical records in 9958
accordance with this section.9959

       (B) Except as provided in divisions (C) and (E) of this9960
section, a health care provider or medical records company that9961
receives a request for a copy of a patient's medical record shall9962
charge not more than the amounts set forth in this section. 9963

       (1) If the request is made by the patient or the patient's 9964
personal representative, total costs for copies and all services 9965
related to those copies shall not exceed the sum of the following:9966

       (a) Except as provided in division (B)(1)(b) of this 9967
section, with respect to data recorded on paper or electronically, 9968
the following amounts:9969

        (i) Two dollars and seventy-four cents per page for the 9970
first ten pages;9971

        (ii) Fifty-seven cents per page for pages eleven through 9972
fifty;9973

       (iii) Twenty-three cents per page for pages fifty-one and 9974
higher;9975

        (b) With respect to data resulting from an x-ray, magnetic 9976
resonance imaging (MRI), or computed axial tomography (CAT) scan 9977
and recorded on paper or film, one dollar and eighty-seven 9978
cents per page;9979

        (c) The actual cost of any related postage incurred by the 9980
health care provider or medical records company.9981

        (2) If the request is made other than by the patient or the 9982
patient's personal representative, total costs for copies and all 9983
services related to those copies shall not exceed the sum of the 9984
following:9985

       (a) An initial fee of sixteen dollars and eighty-four cents, 9986
which shall compensate for the records search;9987

       (b) Except as provided in division (B)(2)(c) of this 9988
section, with respect to data recorded on paper or electronically,9989
the following amounts:9990

       (i) One dollar and eleven cents per page for the first ten 9991
pages;9992

       (ii) Fifty-seven cents per page for pages eleven through 9993
fifty;9994

       (iii) Twenty-three cents per page for pages fifty-one and 9995
higher.9996

       (c) With respect to data resulting from an x-ray, magnetic 9997
resonance imaging (MRI), or computed axial tomography (CAT) scan 9998
and recorded on paper or film, one dollar and eighty-seven 9999
cents per page;10000

       (d) The actual cost of any related postage incurred by the10001
health care provider or medical records company.10002

       (C)(1) On request, a health care provider or medical records 10003
company shall provide one copy of the patient's medical record 10004
and one copy of any records regarding treatment performed 10005
subsequent to the original request, not including copies of 10006
records already provided, without charge to the following:10007

       (a) The bureau of workers' compensation, in accordance with10008
Chapters 4121. and 4123. of the Revised Code and the rules adopted10009
under those chapters;10010

       (b) The industrial commission, in accordance with Chapters10011
4121. and 4123. of the Revised Code and the rules adopted under10012
those chapters;10013

       (c) The department of job and family services or a county 10014
department of job and family services, in accordance with 10015
Chapters 5101. and 5111. of the Revised Code and the rules adopted 10016
under those chapters;10017

       (d) The attorney general, in accordance with sections 2743.51 10018
to 2743.72 of the Revised Code and any rules that may be adopted 10019
under those sections;10020

       (e) A patient, patient's personal representative, or 10021
authorized person if the medical record is necessary to support a 10022
claim under Title II or Title XVI of the "Social Security Act," 4910023
Stat. 620 (1935), 42 U.S.C.A. 401 and 1381, as amended, or the 10024
supplemental security income program and the request is 10025
accompanied by documentation that a claim has been filed.10026

       (2) Nothing in division (C)(1) of this section requires a 10027
health care provider or medical records company to provide a copy 10028
without charge to any person or entity not listed in division 10029
(C)(1) of this section.10030

       (D) Division (C) of this section shall not be construed to10031
supersede any rule of the bureau of workers' compensation, the10032
industrial commission, or the department of job and family10033
services.10034

       (E) A health care provider or medical records company may10035
enter into a contract with either of the following for the copying 10036
of medical records at a fee other than as provided in division (B) 10037
of this section:10038

       (1) A patient, a patient's personal representative, or an 10039
authorized person;10040

       (2) An insurer authorized under Title XXXIX of the Revised 10041
Code to do the business of sickness and accident insurance in this 10042
state or health insuring corporations holding a certificate of 10043
authority under Chapter 1751. of the Revised Code.10044

       (F) This section does not apply to medical records the 10045
copying of which is covered by section 173.20 of the Revised Code 10046
or by 42 C.F.R. 483.10.10047

       Sec. 3701.881.  (A) As used in this section:10048

       (1) "Applicant" means both of the following:10049

       (a) A person who is under final consideration for appointment 10050
to or employment with a home health agency in a position as a 10051
person responsible for the care, custody, or control of a child;10052

       (b) A person who is under final consideration for employment 10053
with a home health agency in a full-time, part-time, or temporary 10054
position that involves providing direct care to an older adult. 10055
With regard to persons providing direct care to older adults, 10056
"applicant" does not include a person who provides direct care as 10057
a volunteer without receiving or expecting to receive any form of10058
remuneration other than reimbursement for actual expenses.10059

       (2) "Criminal records check" and "older adult" have the same 10060
meanings as in section 109.572 of the Revised Code.10061

       (3) "Home health agency" means a person or government entity, 10062
other than a nursing home, residential care facility, or hospice 10063
care program, that has the primary function of providing any of 10064
the following services to a patient at a place of residence used 10065
as the patient's home:10066

       (a) Skilled nursing care;10067

       (b) Physical therapy;10068

       (c) Speech-language pathology;10069

       (d) Occupational therapy;10070

       (e) Medical social services;10071

       (f) Home health aide services.10072

       (4) "Home health aide services" means any of the following 10073
services provided by an individual employed with or contracted for 10074
by a home health agency:10075

       (a) Hands-on bathing or assistance with a tub bath or shower;10076

       (b) Assistance with dressing, ambulation, and toileting;10077

       (c) Catheter care but not insertion;10078

       (d) Meal preparation and feeding.10079

       (5) "Hospice care program" has the same meaning as in section 10080
3712.01 of the Revised Code.10081

       (6) "Medical social services" means services provided by a 10082
social worker under the direction of a patient's attending 10083
physician.10084

       (7) "Minor drug possession offense" has the same meaning as 10085
in section 2925.01 of the Revised Code.10086

       (8) "Nursing home," "residential care facility," and "skilled 10087
nursing care" have the same meanings as in section 3721.01 of the 10088
Revised Code.10089

       (9) "Occupational therapy" has the same meaning as in section 10090
4755.04 of the Revised Code.10091

       (10) "Physical therapy" has the same meaning as in section 10092
4755.40 of the Revised Code.10093

       (11) "Social worker" means a person licensed under Chapter 10094
4757. of the Revised Code to practice as a social worker or 10095
independent social worker.10096

       (12) "Speech-language pathology" has the same meaning as in 10097
section 4753.01 of the Revised Code.10098

       (B)(1) Except as provided in division (I) of this section, 10099
the chief administrator of a home health agency shall request the 10100
superintendent of the bureau of criminal identification and 10101
investigation to conduct a criminal records check with respect to 10102
each applicant. If the position may involve both responsibility 10103
for the care, custody, or control of a child and provision of 10104
direct care to an older adult, the chief administrator shall 10105
request that the superintendent conduct a single criminal records 10106
check for the applicant. If an applicant for whom a criminal 10107
records check request is required under this division does not 10108
present proof of having been a resident of this state for the 10109
five-year period immediately prior to the date upon which the 10110
criminal records check is requested or does not provide evidence 10111
that within that five-year period the superintendent has requested 10112
information about the applicant from the federal bureau of10113
investigation in a criminal records check, the chief administrator 10114
shall request that the superintendent obtain information from the 10115
federal bureau of investigation as a part of the criminal records 10116
check for the applicant. Even if an applicant for whom a criminal 10117
records check request is required under this division presents 10118
proof that the applicant has been a resident of this state for 10119
that five-year period, the chief administrator may request that 10120
the superintendent include information from the federal bureau of 10121
investigation in the criminal records check.10122

       (2) Any person required by division (B)(1) of this section to 10123
request a criminal records check shall provide to each applicant 10124
for whom a criminal records check request is required under that10125
division a copy of the form prescribed pursuant to division (C)(1) 10126
of section 109.572 of the Revised Code and a standard impression10127
sheet prescribed pursuant to division (C)(2) of section 109.572 of 10128
the Revised Code, obtain the completed form and impression sheet 10129
from each applicant, and forward the completed form and impression 10130
sheet to the superintendent of the bureau of criminal 10131
identification and investigation at the time the chief10132
administrator requests a criminal records check pursuant to10133
division (B)(1) of this section.10134

       (3) An applicant who receives pursuant to division (B)(2) of 10135
this section a copy of the form prescribed pursuant to division 10136
(C)(1) of section 109.572 of the Revised Code and a copy of an 10137
impression sheet prescribed pursuant to division (C)(2) of that 10138
section and who is requested to complete the form and provide a 10139
set of fingerprint impressions shall complete the form or provide 10140
all the information necessary to complete the form and shall 10141
provide the impression sheets with the impressions of the10142
applicant's fingerprints. If an applicant, upon request, fails to 10143
provide the information necessary to complete the form or fails to10144
provide fingerprint impressions, the home health agency shall not 10145
employ that applicant for any position for which a criminal 10146
records check is required by division (B)(1) of this section.10147

       (C)(1) Except as provided in rules adopted by the department 10148
of health in accordance with division (F) of this section and 10149
subject to division (C)(3) of this section, no home health agency 10150
shall employ a person as a person responsible for the care, 10151
custody, or control of a child if the person previously has been 10152
convicted of or pleaded guilty to any of the following:10153

       (a) A violation of section 2903.01, 2903.02, 2903.03,10154
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,10155
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05, 10156
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23, 10157
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 10158
2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 2919.24, 2919.25, 10159
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05, 10160
2925.06, or 3716.11 of the Revised Code, a violation of section 10161
2905.04 of the Revised Code as it existed prior to July 1, 1996, a 10162
violation of section 2919.23 of the Revised Code that would have 10163
been a violation of section 2905.04 of the Revised Code as it 10164
existed prior to July 1, 1996, had the violation been committed 10165
prior to that date, a violation of section 2925.11 of the Revised 10166
Code that is not a minor drug possession offense, or felonious 10167
sexual penetration in violation of former section 2907.12 of the 10168
Revised Code;10169

       (b) A violation of an existing or former law of this state, 10170
any other state, or the United States that is substantially 10171
equivalent to any of the offenses listed in division (C)(1)(a) of 10172
this section.10173

       (2) Except as provided in rules adopted by the department of 10174
health in accordance with division (F) of this section and subject 10175
to division (C)(3) of this section, no home health agency shall 10176
employ a person in a position that involves providing direct care 10177
to an older adult if the person previously has been convicted of 10178
or pleaded guilty to any of the following:10179

       (a) A violation of section 2903.01, 2903.02, 2903.03, 10180
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 10181
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,10182
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 10183
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 10184
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,10185
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 10186
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 10187
2925.22, 2925.23, or 3716.11 of the Revised Code.10188

       (b) A violation of an existing or former law of this state,10189
any other state, or the United States that is substantially 10190
equivalent to any of the offenses listed in division (C)(2)(a) of 10191
this section.10192

       (3)(a) A home health agency may employ conditionally an 10193
applicant for whom a criminal records check request is required10194
under division (B) of this section as a person responsible for the10195
care, custody, or control of a child until the criminal records 10196
check regarding the applicant required by this section is 10197
completed and the agency receives the results of the criminal 10198
records check. If the results of the criminal records check 10199
indicate that, pursuant to division (C)(1) of this section, the 10200
applicant does not qualify for employment, the agency shall10201
release the applicant from employment unless the agency chooses to 10202
employ the applicant pursuant to division (F) of this section.10203

       (b)(i) A home health agency may employ conditionally an10204
applicant for whom a criminal records check request is required 10205
under division (B) of this section in a position that involves 10206
providing direct care to an older adult or in a position that 10207
involves both responsibility for the care, custody, and control of 10208
a child and the provision of direct care to older adults prior to 10209
obtaining the results of a criminal records check regarding the 10210
individual, provided that the agency shall request a criminal 10211
records check regarding the individual in accordance with division 10212
(B)(1) of this section not later than five business days after the 10213
individual begins conditional employment. In the circumstances 10214
described in division (I)(2) of this section, a home health agency 10215
may employ conditionally in a position that involves providing 10216
direct care to an older adult an applicant who has been referred 10217
to the home health agency by an employment service that supplies 10218
full-time, part-time, or temporary staff for positions involving 10219
the direct care of older adults and for whom, pursuant to that 10220
division, a criminal records check is not required under division 10221
(B) of this section. In the circumstances described in division10222
(I)(4) of this section, a home health agency may employ 10223
conditionally in a position that involves both responsibility for 10224
the care, custody, and control of a child and the provision of 10225
direct care to older adults an applicant who has been referred to 10226
the home health agency by an employment service that supplies 10227
full-time, part-time, or temporary staff for positions involving 10228
both responsibility for the care, custody, and control of a child 10229
and the provision of direct care to older adults and for whom, 10230
pursuant to that division, a criminal records check is not 10231
required under division (B) of this section.10232

       (ii) A home health agency that employs an individual 10233
conditionally under authority of division (C)(3)(b)(i) of this 10234
section shall terminate the individual's employment if the results 10235
of the criminal records check requested under division (B)(1) of 10236
this section or described in division (I)(2) or (4) of this 10237
section, other than the results of any request for information 10238
from the federal bureau of investigation, are not obtained within 10239
the period ending thirty days after the date the request is made. 10240
Regardless of when the results of the criminal records check are 10241
obtained, if the individual was employed conditionally in a 10242
position that involves the provision of direct care to older 10243
adults and the results indicate that the individual has been 10244
convicted of or pleaded guilty to any of the offenses listed or 10245
described in division (C)(2) of this section, or if the individual 10246
was employed conditionally in a position that involves both 10247
responsibility for the care, custody, and control of a child and 10248
the provision of direct care to older adults and the results 10249
indicate that the individual has been convicted of or pleaded 10250
guilty to any of the offenses listed or described in division 10251
(C)(1) or (2) of this section, the agency shall terminate the 10252
individual's employment unless the agency chooses to employ the 10253
individual pursuant to division (F) of this section. Termination 10254
of employment under this division shall be considered just cause 10255
for discharge for purposes of division (D)(2) of section 4141.29 10256
of the Revised Code if the individual makes any attempt to deceive 10257
the agency about the individual's criminal record.10258

       (D)(1) Each home health agency shall pay to the bureau of10259
criminal identification and investigation the fee prescribed10260
pursuant to division (C)(3) of section 109.572 of the Revised Code 10261
for each criminal records check conducted in accordance with that 10262
section upon the request pursuant to division (B)(1) of this 10263
section of the chief administrator of the home health agency.10264

       (2) A home health agency may charge an applicant a fee for10265
the costs it incurs in obtaining a criminal records check under10266
this section, unless the medical assistancemedicaid program 10267
established under Chapter 5111. of the Revised Code reimburses the 10268
agency for the costs. A fee charged under division (D)(2) of this10269
section shall not exceed the amount of fees the agency pays under 10270
division (D)(1) of this section. If a fee is charged under 10271
division (D)(2) of this section, the agency shall notify the 10272
applicant at the time of the applicant's initial application for 10273
employment of the amount of the fee and that, unless the fee is 10274
paid, the agency will not consider the applicant for employment.10275

       (E) The report of any criminal records check conducted by the 10276
bureau of criminal identification and investigation in accordance 10277
with section 109.572 of the Revised Code and pursuant to a request 10278
made under division (B)(1) of this section is not a public record 10279
for the purposes of section 149.43 of the Revised Code and shall 10280
not be made available to any person other than the following:10281

       (1) The individual who is the subject of the criminal records 10282
check or the individual's representative;10283

       (2) The home health agency requesting the criminal records 10284
check or its representative;10285

       (3) The administrator of any other facility, agency, or 10286
program that provides direct care to older adults that is owned or 10287
operated by the same entity that owns or operates the home health 10288
agency;10289

       (4) Any court, hearing officer, or other necessary individual 10290
involved in a case dealing with a denial of employment of the10291
applicant or dealing with employment or unemployment benefits of 10292
the applicant;10293

       (5) Any person to whom the report is provided pursuant to, 10294
and in accordance with, division (I)(1), (2), (3), or (4) of this 10295
section.10296

       (F) The department of health shall adopt rules in accordance10297
with Chapter 119. of the Revised Code to implement this section. 10298
The rules shall specify circumstances under which the home health 10299
agency may employ a person who has been convicted of or pleaded 10300
guilty to an offense listed or described in division (C)(1) of10301
this section but who meets standards in regard to rehabilitation 10302
set by the department or employ a person who has been convicted of 10303
or pleaded guilty to an offense listed or described in division 10304
(C)(2) of this section but meets personal character standards set 10305
by the department.10306

       (G) Any person required by division (B)(1) of this section to 10307
request a criminal records check shall inform each person, at the 10308
time of initial application for employment that the person is 10309
required to provide a set of fingerprint impressions and that a 10310
criminal records check is required to be conducted and10311
satisfactorily completed in accordance with section 109.572 of the 10312
Revised Code if the person comes under final consideration for10313
appointment or employment as a precondition to employment for that 10314
position.10315

       (H) In a tort or other civil action for damages that is10316
brought as the result of an injury, death, or loss to person or10317
property caused by an individual who a home health agency employs 10318
in a position that involves providing direct care to older adults, 10319
all of the following shall apply:10320

       (1) If the agency employed the individual in good faith and 10321
reasonable reliance on the report of a criminal records check 10322
requested under this section, the agency shall not be found 10323
negligent solely because of its reliance on the report, even if 10324
the information in the report is determined later to have been 10325
incomplete or inaccurate;10326

       (2) If the agency employed the individual in good faith on a 10327
conditional basis pursuant to division (C)(3)(b) of this section, 10328
the agency shall not be found negligent solely because it employed10329
the individual prior to receiving the report of a criminal records 10330
check requested under this section;10331

       (3) If the agency in good faith employed the individual10332
according to the personal character standards established in rules 10333
adopted under division (F) of this section, the agency shall not 10334
be found negligent solely because the individual prior to being 10335
employed had been convicted of or pleaded guilty to an offense 10336
listed or described in division (C)(1) or (2) of this section.10337

       (I)(1) The chief administrator of a home health agency is not10338
required to request that the superintendent of the bureau of 10339
criminal identification and investigation conduct a criminal 10340
records check of an applicant for a position that involves the10341
provision of direct care to older adults if the applicant has been10342
referred to the agency by an employment service that supplies 10343
full-time, part-time, or temporary staff for positions involving 10344
the direct care of older adults and both of the following apply:10345

       (a) The chief administrator receives from the employment10346
service or the applicant a report of the results of a criminal10347
records check regarding the applicant that has been conducted by10348
the superintendent within the one-year period immediately10349
preceding the applicant's referral;10350

       (b) The report of the criminal records check demonstrates10351
that the person has not been convicted of or pleaded guilty to an 10352
offense listed or described in division (C)(2) of this section, or 10353
the report demonstrates that the person has been convicted of or 10354
pleaded guilty to one or more of those offenses, but the home 10355
health agency chooses to employ the individual pursuant to 10356
division (F) of this section.10357

       (2) The chief administrator of a home health agency is not 10358
required to request that the superintendent of the bureau of 10359
criminal identification and investigation conduct a criminal 10360
records check of an applicant for a position that involves 10361
providing direct care to older adults and may employ the applicant 10362
conditionally in a position of that nature as described in this 10363
division, if the applicant has been referred to the agency by an 10364
employment service that supplies full-time, part-time, or 10365
temporary staff for positions involving the direct care of older 10366
adults and if the chief administrator receives from the employment 10367
service or the applicant a letter from the employment service that10368
is on the letterhead of the employment service, dated, and signed 10369
by a supervisor or another designated official of the employment 10370
service and that states that the employment service has requested 10371
the superintendent to conduct a criminal records check regarding 10372
the applicant, that the requested criminal records check will 10373
include a determination of whether the applicant has been 10374
convicted of or pleaded guilty to any offense listed or described 10375
in division (C)(2) of this section, that, as of the date set forth 10376
on the letter, the employment service had not received the results 10377
of the criminal records check, and that, when the employment 10378
service receives the results of the criminal records check, it 10379
promptly will send a copy of the results to the home health 10380
agency. If a home health agency employs an applicant conditionally 10381
in accordance with this division, the employment service, upon its 10382
receipt of the results of the criminal records check, promptly 10383
shall send a copy of the results to the home health agency, and10384
division (C)(3)(b) of this section applies regarding the 10385
conditional employment.10386

       (3) The chief administrator of a home health agency is not 10387
required to request that the superintendent of the bureau of10388
criminal identification and investigation conduct a criminal10389
records check of an applicant for a position that involves both10390
responsibility for the care, custody, and control of a child and10391
the provision of direct care to older adults if the applicant has 10392
been referred to the agency by an employment service that supplies 10393
full-time, part-time, or temporary staff for positions involving 10394
both responsibility for the care, custody, and control of a child 10395
and the provision of direct care to older adults and both of the 10396
following apply:10397

       (a) The chief administrator receives from the employment 10398
service or applicant a report of a criminal records check of the 10399
type described in division (I)(1)(a) of this section;10400

       (b) The report of the criminal records check demonstrates 10401
that the person has not been convicted of or pleaded guilty to an 10402
offense listed or described in division (C)(1) or (2) of this 10403
section, or the report demonstrates that the person has been 10404
convicted of or pleaded guilty to one or more of those offenses, 10405
but the home health agency chooses to employ the individual 10406
pursuant to division (F) of this section.10407

       (4) The chief administrator of a home health agency is not 10408
required to request that the superintendent of the bureau of10409
criminal identification and investigation conduct a criminal10410
records check of an applicant for a position that involves both10411
responsibility for the care, custody, and control of a child and10412
the provision of direct care to older adults and may employ the10413
applicant conditionally in a position of that nature as described 10414
in this division, if the applicant has been referred to the agency 10415
by an employment service that supplies full-time, part-time, or10416
temporary staff for positions involving both responsibility for10417
the care, custody, and control of a child and the direct care of10418
older adults and if the chief administrator receives from the10419
employment service or the applicant a letter from the employment 10420
service that is on the letterhead of the employment service, 10421
dated, and signed by a supervisor or another designated official 10422
of the employment service and that states that the employment 10423
service has requested the superintendent to conduct a criminal 10424
records check regarding the applicant, that the requested criminal 10425
records check will include a determination of whether the 10426
applicant has been convicted of or pleaded guilty to any offense 10427
listed or described in division (C)(1) or (2) of this section, 10428
that, as of the date set forth on the letter, the employment 10429
service had not received the results of the criminal records 10430
check, and that, when the employment service receives the results 10431
of the criminal records check, it promptly will send a copy of the 10432
results to the home health agency. If a home health agency employs 10433
an applicant conditionally in accordance with this division, the 10434
employment service, upon its receipt of the results of the 10435
criminal records check, promptly shall send a copy of the results 10436
to the home health agency, and division (C)(3)(b) of this section 10437
applies regarding the conditional employment.10438

       Sec. 3702.30.  (A) As used in this section:10439

       (1) "Ambulatory surgical facility" means a facility, whether10440
or not part of the same organization as a hospital, that is10441
located in a building distinct from another in which inpatient10442
care is provided, and to which any of the following apply:10443

       (a) Outpatient surgery is routinely performed in the10444
facility, and the facility functions separately from a hospital's10445
inpatient surgical service and from the offices of private10446
physicians, podiatrists, and dentists.10447

       (b) Anesthesia is administered in the facility by an10448
anesthesiologist or certified registered nurse anesthetist, and10449
the facility functions separately from a hospital's inpatient10450
surgical service and from the offices of private physicians,10451
podiatrists, and dentists.10452

       (c) The facility applies to be certified by the United States 10453
centers for medicare and medicaid services as an ambulatory10454
surgical center for purposes of reimbursement under Part B of the10455
medicare program, Part B of Title XVIII of the "Social Security10456
Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended.10457

       (d) The facility applies to be certified by a national10458
accrediting body approved by the centers for medicare and medicaid 10459
services for purposes of deemed compliance with the conditions for 10460
participating in the medicare program as an ambulatory surgical 10461
center.10462

       (e) The facility bills or receives from any third-party10463
payer, governmental health care program, or other person or10464
government entity any ambulatory surgical facility fee that is10465
billed or paid in addition to any fee for professional services.10466

       (f) The facility is held out to any person or government10467
entity as an ambulatory surgical facility or similar facility by10468
means of signage, advertising, or other promotional efforts.10469

       "Ambulatory surgical facility" does not include a hospital10470
emergency department.10471

       (2) "Ambulatory surgical facility fee" means a fee for10472
certain overhead costs associated with providing surgical services10473
in an outpatient setting. A fee is an ambulatory surgical facility 10474
fee only if it directly or indirectly pays for costs associated 10475
with any of the following:10476

       (a) Use of operating and recovery rooms, preparation areas,10477
and waiting rooms and lounges for patients and relatives;10478

       (b) Administrative functions, record keeping, housekeeping,10479
utilities, and rent;10480

       (c) Services provided by nurses, orderlies, technical10481
personnel, and others involved in patient care related to10482
providing surgery.10483

       "Ambulatory surgical facility fee" does not include any10484
additional payment in excess of a professional fee that is10485
provided to encourage physicians, podiatrists, and dentists to10486
perform certain surgical procedures in their office or their group10487
practice's office rather than a health care facility, if the10488
purpose of the additional fee is to compensate for additional cost10489
incurred in performing office-based surgery.10490

       (3) "Governmental health care program" has the same meaning10491
as in section 4731.65 of the Revised Code.10492

       (4) "Health care facility" means any of the following:10493

       (a) An ambulatory surgical facility;10494

       (b) A freestanding dialysis center;10495

       (c) A freestanding inpatient rehabilitation facility;10496

       (d) A freestanding birthing center;10497

       (e) A freestanding radiation therapy center;10498

       (f) A freestanding or mobile diagnostic imaging center.10499

       (5) "Third-party payer" has the same meaning as in section10500
3901.38 of the Revised Code.10501

       (B) By rule adopted in accordance with sections 3702.12 and10502
3702.13 of the Revised Code, the director of health shall10503
establish quality standards for health care facilities. The10504
standards may incorporate accreditation standards or other quality10505
standards established by any entity recognized by the director.10506

       (C) Every ambulatory surgical facility shall require that10507
each physician who practices at the facility comply with all10508
relevant provisions in the Revised Code that relate to the10509
obtaining of informed consent from a patient.10510

       (D) The director shall issue a license to each health care10511
facility that makes application for a license and demonstrates to10512
the director that it meets the quality standards established by10513
the rules adopted under division (B) of this section and satisfies10514
the informed consent compliance requirements specified in division10515
(C) of this section.10516

       (E)(1) Except as provided in section 3702.301 of the Revised 10517
Code, no health care facility shall operate without a license 10518
issued under this section.10519

       (2) If the department of health finds that a physician who10520
practices at a health care facility is not complying with any10521
provision of the Revised Code related to the obtaining of informed10522
consent from a patient, the department shall report its finding to10523
the state medical board, the physician, and the health care10524
facility.10525

       (3) This division does not create, and shall not be construed10526
as creating, a new cause of action or substantive legal right10527
against a health care facility and in favor of a patient who10528
allegedly sustains harm as a result of the failure of the10529
patient's physician to obtain informed consent from the patient10530
prior to performing a procedure on or otherwise caring for the10531
patient in the health care facility.10532

       (F) The rules adopted under division (B) of this section10533
shall include all of the following:10534

       (1) Provisions governing application for, renewal,10535
suspension, and revocation of a license under this section;10536

       (2) Provisions governing orders issued pursuant to section10537
3702.32 of the Revised Code for a health care facility to cease10538
its operations or to prohibit certain types of services provided10539
by a health care facility;10540

       (3) Provisions governing the imposition under section 3702.32 10541
of the Revised Code of civil penalties for violations of this 10542
section or the rules adopted under this section, including a scale 10543
for determining the amount of the penalties.10544

       (G) An ambulatory surgical facility that performs or induces 10545
abortions shall comply with section 3701.791 of the Revised Code.10546

       Sec. 3702.31.  (A) The quality monitoring and inspection fund 10547
is hereby created in the state treasury. The director of health 10548
shall use the fund to administer and enforce this section and 10549
sections 3702.11 to 3702.20, 3702.30, 3702.301, and 3702.32 of the10550
Revised Code and rules adopted pursuant to those sections. The10551
director shall deposit in the fund any moneys collected pursuant10552
to this section or section 3702.32 of the Revised Code. All10553
investment earnings of the fund shall be credited to the fund.10554

       (B) The director of health shall adopt rules pursuant to10555
Chapter 119. of the Revised Code establishing fees for both of the10556
following:10557

       (1) Initial and renewal license applications submitted under10558
section 3702.30 of the Revised Code. The fees established under10559
division (B)(1) of this section shall not exceed the actual and10560
necessary costs of performing the activities described in division10561
(A) of this section.10562

       (2) Inspections conducted under section 3702.15 or 3702.30 of 10563
the Revised Code. The fees established under division (B)(2) of 10564
this section shall not exceed the actual and necessary costs10565
incurred during an inspection, including any indirect costs10566
incurred by the department for staff, salary, or other10567
administrative costs. The director of health shall provide to10568
each health care facility or provider inspected pursuant to10569
section 3702.15 or 3702.30 of the Revised Code a written statement10570
of the fee. The statement shall itemize and total the costs10571
incurred. Within fifteen days after receiving a statement from10572
the director, the facility or provider shall forward the total10573
amount of the fee to the director.10574

       (3) The fees described in divisions (B)(1) and (2) of this10575
section shall meet both of the following requirements:10576

       (a) For each service described in section 3702.11 of the10577
Revised Code, the fee shall not exceed one thousand seven hundred10578
fifty dollars annually, except that the total fees charged to a10579
health care provider under this section shall not exceed five10580
thousand dollars annually.10581

       (b) The fee shall exclude any costs reimbursable by the10582
United States centers for medicare and medicaid services as part 10583
of the certification process for the medicare program established 10584
under Title XVIII of the "Social Security Act," 79 Stat. 286 10585
(1935), 42 U.S.C.A. 1395, as amended, and the medicaid program 10586
established under Title XIX of the "Social Security Act," 79 Stat. 10587
286 (1965), 42 U.S.C. 1396.10588

       (4) The director shall not establish a fee for any service10589
for which a licensure or inspection fee is paid by the health care10590
provider to a state agency for the same or similar licensure or10591
inspection.10592

       Sec. 3702.51.  As used in sections 3702.51 to 3702.62 of the10593
Revised Code:10594

       (A) "Applicant" means any person that submits an application10595
for a certificate of need and who is designated in the application10596
as the applicant.10597

       (B) "Person" means any individual, corporation, business10598
trust, estate, firm, partnership, association, joint stock10599
company, insurance company, government unit, or other entity.10600

       (C) "Certificate of need" means a written approval granted by10601
the director of health to an applicant to authorize conducting a10602
reviewable activity.10603

       (D) "Health service area" means a geographic region10604
designated by the director of health under section 3702.58 of the10605
Revised Code.10606

       (E) "Health service" means a clinically related service, such10607
as a diagnostic, treatment, rehabilitative, or preventive service.10608

       (F) "Health service agency" means an agency designated to10609
serve a health service area in accordance with section 3702.58 of10610
the Revised Code.10611

       (G) "Health care facility" means:10612

       (1) A hospital registered under section 3701.07 of the10613
Revised Code;10614

       (2) A nursing home licensed under section 3721.02 of the10615
Revised Code, or by a political subdivision certified under10616
section 3721.09 of the Revised Code;10617

       (3) A county home or a county nursing home as defined in10618
section 5155.31 of the Revised Code that is certified under Title10619
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 4210620
U.S.C.A. 301, as amendedmedicare program;10621

       (4) A freestanding dialysis center;10622

       (5) A freestanding inpatient rehabilitation facility;10623

       (6) An ambulatory surgical facility;10624

       (7) A freestanding cardiac catheterization facility;10625

       (8) A freestanding birthing center;10626

       (9) A freestanding or mobile diagnostic imaging center;10627

       (10) A freestanding radiation therapy center.10628

       A health care facility does not include the offices of10629
private physicians and dentists whether for individual or group10630
practice, residential facilities licensed under section 5123.19 of10631
the Revised Code, or an institution for the sick that is operated 10632
exclusively for patients who use spiritual means for healing and 10633
for whom the acceptance of medical care is inconsistent with their10634
religious beliefs, accredited by a national accrediting 10635
organization, exempt from federal income taxation under section 10636
501 of the Internal Revenue Code of 1986, 100 Stat. 2085, 26 10637
U.S.C.A. 1, as amended, and providing twenty-four hour nursing 10638
care pursuant to the exemption in division (E) of section 4723.32 10639
of the Revised Code from the licensing requirements of Chapter 10640
4723. of the Revised Code.10641

       (H) "Medical equipment" means a single unit of medical10642
equipment or a single system of components with related functions10643
that is used to provide health services.10644

       (I) "Third-party payer" means a health insuring corporation10645
licensed under Chapter 1751. of the Revised Code, a health10646
maintenance organization as defined in division (K) of this10647
section, an insurance company that issues sickness and accident10648
insurance in conformity with Chapter 3923. of the Revised Code, a10649
state-financed health insurance program under Chapter 3701.,or10650
4123., or 5111. of the Revised Code, the medicaid program, or any 10651
self-insurance plan.10652

       (J) "Government unit" means the state and any county,10653
municipal corporation, township, or other political subdivision of10654
the state, or any department, division, board, or other agency of10655
the state or a political subdivision.10656

       (K) "Health maintenance organization" means a public or10657
private organization organized under the law of any state that is10658
qualified under section 1310(d) of Title XIII of the "Public10659
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e-9.10660

       (L) "Existing health care facility" means either of the 10661
following:10662

       (1) A health care facility that is licensed or otherwise 10663
authorized to operate in this state in accordance with applicable 10664
law, including a county home or a county nursing home that is 10665
certified as of February 1, 2008, under Title XVIII or Title XIX 10666
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, 10667
as amended, is staffed and equipped to provide health care 10668
services, and is actively providing health services;10669

       (2) A health care facility that is licensed or otherwise 10670
authorized to operate in this state in accordance with applicable 10671
law, including a county home or a county nursing home that is 10672
certified as of February 1, 2008, under Title XVIII or Title XIX 10673
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, 10674
as amended, or that has beds registered under section 3701.07 of 10675
the Revised Code as skilled nursing beds or long-term care beds 10676
and has provided services for at least three hundred sixty-five 10677
consecutive days within the twenty-four months immediately 10678
preceding the date a certificate of need application is filed with 10679
the director of health.10680

       (M) "State" means the state of Ohio, including, but not10681
limited to, the general assembly, the supreme court, the offices10682
of all elected state officers, and all departments, boards,10683
offices, commissions, agencies, institutions, and other10684
instrumentalities of the state of Ohio. "State" does not include10685
political subdivisions.10686

       (N) "Political subdivision" means a municipal corporation,10687
township, county, school district, and all other bodies corporate10688
and politic responsible for governmental activities only in10689
geographic areas smaller than that of the state to which the10690
sovereign immunity of the state attaches.10691

       (O) "Affected person" means:10692

       (1) An applicant for a certificate of need, including an10693
applicant whose application was reviewed comparatively with the10694
application in question;10695

       (2) The person that requested the reviewability ruling in10696
question;10697

       (3) Any person that resides or regularly uses health care10698
facilities within the geographic area served or to be served by10699
the health care services that would be provided under the10700
certificate of need or reviewability ruling in question;10701

       (4) Any health care facility that is located in the health10702
service area where the health care services would be provided10703
under the certificate of need or reviewability ruling in question;10704

       (5) Third-party payers that reimburse health care facilities10705
for services in the health service area where the health care10706
services would be provided under the certificate of need or10707
reviewability ruling in question;10708

       (6) Any other person who testified at a public hearing held10709
under division (B) of section 3702.52 of the Revised Code or10710
submitted written comments in the course of review of the10711
certificate of need application in question.10712

       (P) "Osteopathic hospital" means a hospital registered under10713
section 3701.07 of the Revised Code that advocates osteopathic10714
principles and the practice and perpetuation of osteopathic10715
medicine by doing any of the following:10716

       (1) Maintaining a department or service of osteopathic10717
medicine or a committee on the utilization of osteopathic10718
principles and methods, under the supervision of an osteopathic10719
physician;10720

       (2) Maintaining an active medical staff, the majority of10721
which is comprised of osteopathic physicians;10722

       (3) Maintaining a medical staff executive committee that has10723
osteopathic physicians as a majority of its members.10724

       (Q) "Ambulatory surgical facility" has the same meaning as in10725
section 3702.30 of the Revised Code.10726

       (R) Except as otherwise provided in division (T) of this10727
section, and until the termination date specified in section10728
3702.511 of the Revised Code, "reviewable activity" means any of10729
the following:10730

       (1) The addition by any person of any of the following health10731
services, regardless of the amount of operating costs or capital10732
expenditures:10733

       (a) A heart, heart-lung, lung, liver, kidney, bowel,10734
pancreas, or bone marrow transplantation service, a stem cell10735
harvesting and reinfusion service, or a service for10736
transplantation of any other organ unless transplantation of the10737
organ is designated by public health council rule not to be a10738
reviewable activity;10739

       (b) A cardiac catheterization service;10740

       (c) An open-heart surgery service;10741

       (d) Any new, experimental medical technology that is10742
designated by rule of the public health council.10743

       (2) The acceptance of high-risk patients, as defined in rules 10744
adopted under section 3702.57 of the Revised Code, by any cardiac10745
catheterization service that was initiated without a certificate 10746
of need pursuant to division (R)(3)(b) of the version of this 10747
section in effect immediately prior to April 20, 1995;10748

       (3)(a) The establishment, development, or construction of a10749
new health care facility other than a new long-term care facility10750
or a new hospital;10751

       (b) The establishment, development, or construction of a new10752
hospital or the relocation of an existing hospital;10753

       (c) The relocation of hospital beds, other than long-term10754
care, perinatal, or pediatric intensive care beds, into or out of10755
a rural area.10756

       (4)(a) The replacement of an existing hospital;10757

       (b) The replacement of an existing hospital obstetric or10758
newborn care unit or freestanding birthing center.10759

       (5)(a) The renovation of a hospital that involves a capital10760
expenditure, obligated on or after June 30, 1995, of five million 10761
dollars or more, not including expenditures for equipment, 10762
staffing, or operational costs. For purposes of division (R)(5)(a) 10763
of this section, a capital expenditure is obligated:10764

       (i) When a contract enforceable under Ohio law is entered10765
into for the construction, acquisition, lease, or financing of a10766
capital asset;10767

       (ii) When the governing body of a hospital takes formal10768
action to commit its own funds for a construction project10769
undertaken by the hospital as its own contractor;10770

       (iii) In the case of donated property, on the date the gift10771
is completed under applicable Ohio law.10772

       (b) The renovation of a hospital obstetric or newborn care10773
unit or freestanding birthing center that involves a capital10774
expenditure of five million dollars or more, not including10775
expenditures for equipment, staffing, or operational costs.10776

       (6) Any change in the health care services, bed capacity, or10777
site, or any other failure to conduct the reviewable activity in10778
substantial accordance with the approved application for which a10779
certificate of need was granted, if the change is made prior to10780
the date the activity for which the certificate was issued ceases10781
to be a reviewable activity;10782

       (7) Any of the following changes in perinatal bed capacity or 10783
pediatric intensive care bed capacity:10784

       (a) An increase in bed capacity;10785

       (b) A change in service or service-level designation of10786
newborn care beds or obstetric beds in a hospital or freestanding10787
birthing center, other than a change of service that is provided10788
within the service-level designation of newborn care or obstetric10789
beds as registered by the department of health;10790

       (c) A relocation of perinatal or pediatric intensive care10791
beds from one physical facility or site to another, excluding the10792
relocation of beds within a hospital or freestanding birthing10793
center or the relocation of beds among buildings of a hospital or10794
freestanding birthing center at the same site.10795

       (8) The expenditure of more than one hundred ten per cent of10796
the maximum expenditure specified in a certificate of need;10797

       (9) Any transfer of a certificate of need issued prior to10798
April 20, 1995, from the person to whom it was issued to another10799
person before the project that constitutes a reviewable activity10800
is completed, any agreement that contemplates the transfer of a10801
certificate of need issued prior to that date upon completion of10802
the project, and any transfer of the controlling interest in an10803
entity that holds a certificate of need issued prior to that date.10804
However, the transfer of a certificate of need issued prior to10805
that date or agreement to transfer such a certificate of need from10806
the person to whom the certificate of need was issued to an10807
affiliated or related person does not constitute a reviewable10808
transfer of a certificate of need for the purposes of this10809
division, unless the transfer results in a change in the person10810
that holds the ultimate controlling interest in the certificate of10811
need.10812

       (10)(a) The acquisition by any person of any of the following 10813
medical equipment, regardless of the amount of operating costs or 10814
capital expenditure:10815

       (i) A cobalt radiation therapy unit;10816

       (ii) A linear accelerator;10817

       (iii) A gamma knife unit.10818

       (b) The acquisition by any person of medical equipment with a10819
cost of two million dollars or more. The cost of acquiring medical 10820
equipment includes the sum of the following:10821

       (i) The greater of its fair market value or the cost of its10822
lease or purchase;10823

       (ii) The cost of installation and any other activities10824
essential to the acquisition of the equipment and its placement10825
into service.10826

       (11) The addition of another cardiac catheterization10827
laboratory to an existing cardiac catheterization service.10828

       (S) Except as provided in division (T) of this section,10829
"reviewable activity" also means any of the following activities,10830
none of which are subject to a termination date:10831

       (1) The establishment, development, or construction of a new10832
long-term care facility;10833

       (2) The replacement of an existing long-term care facility;10834

       (3) The renovation of a long-term care facility that involves 10835
a capital expenditure of two million dollars or more, not10836
including expenditures for equipment, staffing, or operational10837
costs;10838

       (4) Any of the following changes in long-term care bed10839
capacity:10840

       (a) An increase in bed capacity;10841

       (b) A relocation of beds from one physical facility or site10842
to another, excluding the relocation of beds within a long-term10843
care facility or among buildings of a long-term care facility at10844
the same site;10845

       (c) A recategorization of hospital beds registered under10846
section 3701.07 of the Revised Code from another registration10847
category to skilled nursing beds or long-term care beds.10848

       (5) Any change in the health services, bed capacity, or site, 10849
or any other failure to conduct the reviewable activity in10850
substantial accordance with the approved application for which a10851
certificate of need concerning long-term care beds was granted, if10852
the change is made within five years after the implementation of10853
the reviewable activity for which the certificate was granted;10854

       (6) The expenditure of more than one hundred ten per cent of10855
the maximum expenditure specified in a certificate of need10856
concerning long-term care beds;10857

       (7) Any transfer of a certificate of need that concerns10858
long-term care beds and was issued prior to April 20, 1995, from10859
the person to whom it was issued to another person before the10860
project that constitutes a reviewable activity is completed, any10861
agreement that contemplates the transfer of such a certificate of10862
need upon completion of the project, and any transfer of the10863
controlling interest in an entity that holds such a certificate of10864
need. However, the transfer of a certificate of need that concerns 10865
long-term care beds and was issued prior to April 20, 1995, or 10866
agreement to transfer such a certificate of need from the person 10867
to whom the certificate was issued to an affiliated or related 10868
person does not constitute a reviewable transfer of a certificate 10869
of need for purposes of this division, unless the transfer results 10870
in a change in the person that holds the ultimate controlling10871
interest in the certificate of need.10872

       (T) "Reviewable activity" does not include any of the10873
following activities:10874

       (1) Acquisition of computer hardware or software;10875

       (2) Acquisition of a telephone system;10876

       (3) Construction or acquisition of parking facilities;10877

       (4) Correction of cited deficiencies that are in violation of 10878
federal, state, or local fire, building, or safety laws and rules 10879
and that constitute an imminent threat to public health or safety;10880

       (5) Acquisition of an existing health care facility that does 10881
not involve a change in the number of the beds, by service, or in 10882
the number or type of health services;10883

       (6) Correction of cited deficiencies identified by10884
accreditation surveys of the joint commission on accreditation of10885
healthcare organizations or of the American osteopathic10886
association;10887

       (7) Acquisition of medical equipment to replace the same or10888
similar equipment for which a certificate of need has been issued10889
if the replaced equipment is removed from service;10890

       (8) Mergers, consolidations, or other corporate10891
reorganizations of health care facilities that do not involve a10892
change in the number of beds, by service, or in the number or type10893
of health services;10894

       (9) Construction, repair, or renovation of bathroom10895
facilities;10896

       (10) Construction of laundry facilities, waste disposal10897
facilities, dietary department projects, heating and air10898
conditioning projects, administrative offices, and portions of10899
medical office buildings used exclusively for physician services;10900

       (11) Acquisition of medical equipment to conduct research10901
required by the United States food and drug administration or10902
clinical trials sponsored by the national institute of health. Use 10903
of medical equipment that was acquired without a certificate of 10904
need under division (T)(11) of this section and for which10905
premarket approval has been granted by the United States food and10906
drug administration to provide services for which patients or10907
reimbursement entities will be charged shall be a reviewable10908
activity.10909

       (12) Removal of asbestos from a health care facility.10910

       Only that portion of a project that meets the requirements of10911
division (T) of this section is not a reviewable activity.10912

       (U) "Small rural hospital" means a hospital that is located10913
within a rural area, has fewer than one hundred beds, and to which10914
fewer than four thousand persons were admitted during the most10915
recent calendar year.10916

       (V) "Children's hospital" means any of the following:10917

       (1) A hospital registered under section 3701.07 of the10918
Revised Code that provides general pediatric medical and surgical10919
care, and in which at least seventy-five per cent of annual10920
inpatient discharges for the preceding two calendar years were10921
individuals less than eighteen years of age;10922

       (2) A distinct portion of a hospital registered under section 10923
3701.07 of the Revised Code that provides general pediatric 10924
medical and surgical care, has a total of at least one hundred 10925
fifty registered pediatric special care and pediatric acute care 10926
beds, and in which at least seventy-five per cent of annual 10927
inpatient discharges for the preceding two calendar years were 10928
individuals less than eighteen years of age;10929

       (3) A distinct portion of a hospital, if the hospital is10930
registered under section 3701.07 of the Revised Code as a10931
children's hospital and the children's hospital meets all the10932
requirements of division (V)(1) of this section.10933

       (W) "Long-term care facility" means any of the following:10934

       (1) A nursing home licensed under section 3721.02 of the10935
Revised Code or by a political subdivision certified under section10936
3721.09 of the Revised Code;10937

       (2) The portion of any facility, including a county home or10938
county nursing home, that is certified as a skilled nursing10939
facility or a nursing facility under Title XVIII or XIX of the10940
"Social Security Act";10941

       (3) The portion of any hospital that contains beds registered 10942
under section 3701.07 of the Revised Code as skilled nursing beds 10943
or long-term care beds.10944

       (X) "Long-term care bed" means a bed in a long-term care10945
facility.10946

       (Y) "Perinatal bed" means a bed in a hospital that is10947
registered under section 3701.07 of the Revised Code as a newborn10948
care bed or obstetric bed, or a bed in a freestanding birthing10949
center.10950

       (Z) "Freestanding birthing center" means any facility in10951
which deliveries routinely occur, regardless of whether the10952
facility is located on the campus of another health care facility,10953
and which is not licensed under Chapter 3711. of the Revised Code10954
as a level one, two, or three maternity unit or a limited10955
maternity unit.10956

       (AA)(1) "Reviewability ruling" means a ruling issued by the10957
director of health under division (A) of section 3702.52 of the10958
Revised Code as to whether a particular proposed project is or is10959
not a reviewable activity.10960

       (2) "Nonreviewability ruling" means a ruling issued under10961
that division that a particular proposed project is not a10962
reviewable activity.10963

       (BB)(1) "Metropolitan statistical area" means an area of this10964
state designated a metropolitan statistical area or primary10965
metropolitan statistical area in United States office of10966
management and budget bulletin no. 93-17, June 30, 1993, and its10967
attachments.10968

       (2) "Rural area" means any area of this state not located10969
within a metropolitan statistical area.10970

       (CC) "County nursing home" has the same meaning as in section 10971
5155.31 of the Revised Code.10972

       Sec. 3702.522.  (A) Reviews of applications for certificates 10973
of need to recategorize hospital beds to skilled nursing beds 10974
shall be conducted in accordance with this division and rules 10975
adopted by the public health council.10976

       (1) No hospital recategorizing beds shall apply for a10977
certificate of need for more than twenty skilled nursing beds.10978

       (2) No beds for which a certificate of need is requested 10979
under this division shall be reviewed under or counted in any 10980
formula developed under public health council rules for the 10981
purpose of determining the number of long-term care beds that may 10982
be needed within the state.10983

       (3) No beds shall be approved under this division unless the 10984
hospital certifies and demonstrates in the application that the 10985
beds will be dedicated to patients with a length of stay of no 10986
more than thirty days.10987

       (4) No beds shall be approved under this division unless the 10988
hospital can satisfactorily demonstrate in the application that it 10989
is routinely unable to place the patients planned for the beds in 10990
accessible skilled nursing facilities.10991

       (5) In developing rules to implement this division, the10992
public health council shall give special attention to the required 10993
documentation of the need for such beds, including the efforts 10994
made by the hospital to place patients in suitable skilled nursing 10995
facilities, and special attention to the appropriate size of units 10996
with such beds given the historical pattern of the applicant 10997
hospital's documented difficulty in placing skilled nursing 10998
patients.10999

       (B) To assist the director of health in monitoring the use of 11000
hospital beds recategorized as skilled nursing beds after August 11001
5, 1989, the public health council shall adopt rules specifying 11002
appropriate quarterly procedures for reporting to the department 11003
of health.11004

       (C) A patient may stay in a hospital bed that, after August 11005
5, 1989, has been recategorized as a skilled nursing bed for more 11006
than thirty days if the hospital is able to demonstrate that it 11007
made a good faith effort to place the patient in an accessible 11008
skilled nursing facility acceptable to the patient within the 11009
thirty-day period, but was unable to do so.11010

       (D) No hospital bed recategorized after August 5, 1989, as a 11011
skilled nursing bed shall be covered by a provider agreement under 11012
the medical assistancemedicaid program established under Chapter 11013
5111. of the Revised Code.11014

       (E) Nothing in this section requires a hospital to place a 11015
patient in any nursing home if the patient does not wish to be 11016
placed in the nursing home. Nothing in this section limits the 11017
ability of a hospital to file a certificate of need application 11018
for the addition of long-term care beds that meet the definition 11019
of "home" in section 3721.01 of the Revised Code. Nothing in this 11020
section limits the ability of the director to grant certificates 11021
of need necessary for hospitals to engage in demonstration 11022
projects authorized by the federal government for the purpose of 11023
enhancing long-term quality of care and cost containment. Nothing 11024
in this section limits the ability of hospitals to develop swing 11025
bed programs in accordance with federal regulations.11026

       No hospital that is granted a certificate of need after11027
August 5, 1989, to recategorize hospital beds as skilled nursing 11028
beds is subject to sections 3721.01 to 3721.09 of the Revised 11029
Code. If the portion of the hospital in which the recategorized 11030
beds are located is certified as a skilled nursing facility under 11031
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 4211032
U.S.C.A. 301, as amendedmedicare program, that portion of the 11033
hospital is subject to sections 3721.10 to 3721.17 and sections 11034
3721.21 to 3721.34 of the Revised Code. If the beds are registered 11035
pursuant to section 3701.07 of the Revised Code as long-term care11036
beds, the beds are subject to sections 3721.505166.20 to 3721.5811037
5166.30 of the Revised Code.11038

       (F) The public health council shall adopt rules authorizing 11039
the creation of one or more nursing home placement clearinghouses. 11040
Any public or private agency or facility may apply to the 11041
department of health to serve as a nursing home placement 11042
clearinghouse, and the rules shall provide the procedure for 11043
application and process for designation of clearinghouses.11044

       The department may approve one or more clearinghouses, but in 11045
no event shall there be more than one nursing home placement 11046
clearinghouse in each county. Any nursing home may list with a 11047
nursing home placement clearinghouse the services it provides and 11048
the types of patients it is approved for and equipped to serve. 11049
The clearinghouse shall make reasonable efforts to update its 11050
information at least every six months.11051

       If an appropriate clearinghouse has been designated, each 11052
hospital granted a certificate of need after August 5, 1989, to 11053
recategorize hospital beds as skilled nursing beds shall, and any 11054
other hospital may, utilize the nursing home placement 11055
clearinghouse prior to admitting a patient to a skilled nursing 11056
bed within the hospital and prior to keeping a patient in a 11057
skilled nursing bed within a hospital in excess of thirty days.11058

       The department shall provide at least annually to all11059
hospitals a list of the designated nursing home placement11060
clearinghouses.11061

       Sec.  3702.591.  As specified in former Section 11 of Am. 11062
Sub. S.B. 50 of the 121st general assembly, as amended by Am. 11063
Sub. H.B. 405 of the 124th general assembly, all of the following 11064
apply:11065

       (A) The removal of former divisions (E) and (F) of section 11066
3702.52 of the Revised Code by Sections 1 and 2 of Am. Sub. S.B. 11067
50 of the 121st general assembly does not release the holders of11068
certificates of need issued under those divisions from complying 11069
with any conditions on which the granting of the certificates of 11070
need was based, including the requirement of former division 11071
(E)(6) of that section that the holders not enter into medicaid11072
provider agreements under Chapter 5111. of the Revised Code and 11073
Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 4211074
U.S.C. 301, as amended, for at least ten years following initial 11075
licensure of the long-term care facilities for which the 11076
certificates were granted.11077

       (B) The repeal of section 3702.55 of the Revised Code by 11078
Section 2 of Am. Sub. S.B. 50 of the 121st general assembly does11079
not release the holders of certificates of need issued under that11080
section from complying with any conditions on which the granting11081
of the certificates of need was based, other than the requirement11082
of division (A)(6) of that section that the holders not seek11083
certification under Title XVIII of the "Social Security Act"11084
medicare program for beds recategorized under the certificates. 11085
That repeal also does not eliminate the requirement that the11086
director of health revoke the licensure of the beds under Chapter11087
3721. of the Revised Code if a person to which their ownership is11088
transferred fails, as required by division (A)(6) of the repealed 11089
section, to file within ten days after the transfer a sworn 11090
statement not to seek certification under Title XIX of the 11091
"Social Security Act"medicaid program for beds recategorized 11092
under the certificates of need.11093

       (C) The repeal of section 3702.56 of the Revised Code by 11094
Section 2 of Am. Sub. S.B. 50 of the 121st general assembly does11095
not release the holders of certificates of need issued under that11096
section from complying with any conditions on which the granting11097
of the certificates of need was based.11098

       Sec. 3702.62.  (A) Any action pursuant to section 140.03, 11099
140.04, 140.05, 307.091, 313.21, 339.01, 339.021, 339.03, 339.06, 11100
339.08, 339.09, 339.12, 339.14, 513.05, 513.07, 513.08, 513.081, 11101
513.12, 513.15, 513.17, 513.171, 749.02, 749.03, 749.14, 749.16, 11102
749.20, 749.25, 749.28, 749.35, 1751.06, or 3707.29 of the Revised 11103
Code shall be taken in accordance with sections 3702.51 to 3702.61 11104
of the Revised Code.11105

       (B) A nursing home certified as an intermediate care facility 11106
for the mentally retarded under Title XIX of the "Social Security 11107
Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amendedmedicaid 11108
program, that is required to apply for licensure as a residential 11109
facility under section 5123.19 of the Revised Code is not, with 11110
respect to the portion of the home certified as an intermediate 11111
care facility for the mentally retarded, subject to sections 11112
3702.51 to 3702.61 of the Revised Code.11113

       Sec. 3702.74.  (A) A primary care physician who has signed a11114
letter of intent under section 3702.73 of the Revised Code and 11115
the director of health may enter into a contract for the 11116
physician's participation in the physician loan repayment 11117
program. The physician's employer or other funding source may 11118
also be a party to the contract.11119

       (B) The contract shall include all of the following11120
obligations:11121

       (1) The primary care physician agrees to provide primary care 11122
services in the health resource shortage area identified in the 11123
letter of intent for at least two years;11124

       (2) When providing primary care services in the health11125
resource shortage area, the primary care physician agrees to do11126
all of the following:11127

       (a) Provide primary care services for a minimum of forty11128
hours per week, of which at least twenty-one hours will be spent 11129
providing patient care in an outpatient or ambulatory setting;11130

       (b) Provide primary care services without regard to a11131
patient's ability to pay;11132

       (c) Meet the conditions prescribed by the "Social Security11133
Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended, and the11134
department of job and family services for participation in the 11135
medicaid program established under Chapter 5111. of the Revised11136
Code and enter into a contract with the department of health care 11137
administration to provide primary care services to medicaid11138
recipients of the medical assistance program;11139

       (d) Meet the conditions established by the department of job11140
and family services for participation in the disability medical 11141
assistance program established under Chapter 5115. of the Revised 11142
Code and enter into a contract with the department to provide 11143
primary care services to recipients of disability medical 11144
assistance.11145

       (3) The department of health agrees, as provided in section11146
3702.75 of the Revised Code, to repay, so long as the primary 11147
care physician performs the service obligation agreed to under 11148
division (B)(1) of this section, all or part of the principal and 11149
interest of a government or other educational loan taken by the 11150
primary care physician for expenses described in section 3702.7511151
of the Revised Code;11152

       (4) The primary care physician agrees to pay the department 11153
of health an amount established by rules adopted under section 11154
3702.79 of the Revised Code if the physician fails to complete 11155
the service obligation agreed to under division (B)(1) of this11156
section.11157

       (C) The contract may include any other terms agreed upon by11158
the parties.11159

       Sec. 3702.91.  (A) An individual who has signed a letter of 11160
intent under section 3702.90 of the Revised Code may enter into a 11161
contract with the director of health for participation in the11162
dentist loan repayment program. A lending institution may also be 11163
a party to the contract.11164

       (B) The contract shall include all of the following11165
obligations:11166

       (1) The individual agrees to provide dental services in the11167
dental health resource shortage area identified in the letter of 11168
intent for at least one year.11169

       (2) When providing dental services in the dental health11170
resource shortage area, the individual agrees to do all of the11171
following:11172

       (a) Provide dental services for a minimum of forty hours per 11173
week;11174

       (b) Provide dental services without regard to a patient's 11175
ability to pay;11176

       (c) Meet the conditions prescribed by the "Social Security11177
Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended, and the11178
department of job and family services for participation in the11179
medicaid program established under Chapter 5111. of the Revised11180
Code and enter into a contract with the department of health care 11181
administration to provide dental services to medicaid recipients.11182

       (3) The department of health agrees, as provided in section11183
3702.85 of the Revised Code, to repay, so long as the individual 11184
performs the service obligation agreed to under division (B)(1) 11185
of this section, all or part of the principal and interest of a 11186
government or other educational loan taken by the individual for 11187
expenses described in section 3702.85 of the Revised Code up to 11188
but not exceeding twenty thousand dollars per year of service.11189

       (4) The individual agrees to pay the department of health 11190
the following as damages if the individual fails to complete the11191
service obligation agreed to under division (B)(1) of this11192
section:11193

       (a) If the failure occurs during the first two years of the11194
service obligation, three times the total amount the department 11195
has agreed to repay under division (B)(3) of this section;11196

       (b) If the failure occurs after the first two years of the11197
service obligation, three times the amount the department is 11198
still obligated to repay under division (B)(3) of this section.11199

       (C) The contract may include any other terms agreed upon by11200
the parties, including an assignment to the department of health11201
of the individual's duty to pay the principal and interest of a11202
government or other educational loan taken by the individual for11203
expenses described in section 3702.85 of the Revised Code. If the 11204
department assumes the individual's duty to pay a loan, the 11205
contract shall set forth the total amount of principal and 11206
interest to be paid, an amortization schedule, and the amount of 11207
each payment to be made under the schedule.11208

       (D) Not later than the thirty-first day of January of each 11209
year, the department of health shall mail to each individual to 11210
whom or on whose behalf repayment is made under the dentist loan 11211
repayment program a statement showing the amount of principal and 11212
interest repaid by the department pursuant to the contract in the 11213
preceding year. The statement shall be sent by ordinary mail with 11214
address correction and forwarding requested in the manner 11215
prescribed by the United States postal service.11216

       Sec. 3712.07.  (A) As used in this section, "terminal care11217
facility for the homeless" means a facility that provides11218
accommodations to homeless individuals who are terminally ill.11219

       (B) A person or public agency licensed under this chapter to 11220
provide a hospice care program may enter into an agreement with a 11221
terminal care facility for the homeless under which hospice care 11222
program services may be provided to individuals residing at the 11223
facility, if all of the following apply:11224

       (1) Each resident of the facility has been diagnosed by a11225
physician as having a terminal condition and an anticipated life11226
expectancy of six months or less;11227

       (2) No resident of the facility has a relative or other11228
person willing or capable of providing the care necessary to cope11229
with histhe resident's terminal illness or is financially capable 11230
of hiring a person to provide such care;11231

       (3) Each resident of the facility is under the direct care of 11232
a physician;11233

       (4) No resident of the facility requires the staff of the11234
facility to administer medication by injection;11235

       (5) The facility does not receive any remuneration, directly 11236
or indirectly, from the residents;11237

       (6) The facility does not receive any remuneration, directly 11238
or indirectly, from the medical assistancemedicaid program11239
established under section 5111.01 of the Revised Code or the11240
medicare program established under Title XVIII of the "Social11241
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended;11242

       (7) The facility meets all applicable state and federal11243
health and safety standards, including standards for fire11244
prevention, maintenance of safe and sanitary conditions, and11245
proper preparation and storage of foods.11246

       (C) Hospice care program services may be provided at a11247
terminal care facility for the homeless only by the personnel of11248
the person or public agency that has entered into an agreement11249
with the facility under this section.11250

       (D) A terminal care facility for the homeless that has11251
entered into an agreement under this section may assist its11252
residents with the self-administration of medication if the11253
medication has been prescribed by a physician and is not11254
administered by injection. In the event that a resident has11255
entered the final stages of dying and is no longer mentally alert, 11256
the facility may administer medication to that resident if the 11257
medication has been prescribed by a physician and is not11258
administered by injection. Determinations of whether an individual 11259
has entered the final stages of dying and is no longer mentally 11260
alert shall be based on directions from the personnel who provide 11261
hospice care program services at the facility.11262

       Sec. 3712.09.  (A) As used in this section:11263

       (1) "Applicant" means a person who is under final11264
consideration for employment with a hospice care program in a 11265
full-time, part-time, or temporary position that involves 11266
providing direct care to an older adult. "Applicant" does not 11267
include a person who provides direct care as a volunteer without 11268
receiving or expecting to receive any form of remuneration other 11269
than reimbursement for actual expenses.11270

       (2) "Criminal records check" and "older adult" have the same 11271
meanings as in section 109.572 of the Revised Code.11272

       (B)(1) Except as provided in division (I) of this section,11273
the chief administrator of a hospice care program shall request 11274
that the superintendent of the bureau of criminal identification 11275
and investigation conduct a criminal records check with respect to 11276
each applicant. If an applicant for whom a criminal records check 11277
request is required under this division does not present proof of 11278
having been a resident of this state for the five-year period 11279
immediately prior to the date the criminal records check is 11280
requested or provide evidence that within that five-year period 11281
the superintendent has requested information about the applicant 11282
from the federal bureau of investigation in a criminal records 11283
check, the chief administrator shall request that the 11284
superintendent obtain information from the federal bureau of 11285
investigation as part of the criminal records check of the 11286
applicant. Even if an applicant for whom a criminal records check 11287
request is required under this division presents proof of having11288
been a resident of this state for the five-year period, the chief11289
administrator may request that the superintendent include11290
information from the federal bureau of investigation in the11291
criminal records check.11292

       (2) A person required by division (B)(1) of this section to 11293
request a criminal records check shall do both of the following:11294

       (a) Provide to each applicant for whom a criminal records 11295
check request is required under that division a copy of the form11296
prescribed pursuant to division (C)(1) of section 109.572 of the 11297
Revised Code and a standard fingerprint impression sheet 11298
prescribed pursuant to division (C)(2) of that section, and obtain 11299
the completed form and impression sheet from the applicant;11300

       (b) Forward the completed form and impression sheet to the 11301
superintendent of the bureau of criminal identification and 11302
investigation.11303

       (3) An applicant provided the form and fingerprint impression 11304
sheet under division (B)(2)(a) of this section who fails to 11305
complete the form or provide fingerprint impressions shall not be 11306
employed in any position for which a criminal records check is 11307
required by this section.11308

       (C)(1) Except as provided in rules adopted by the public 11309
health council in accordance with division (F) of this section and 11310
subject to division (C)(2) of this section, no hospice care 11311
program shall employ a person in a position that involves 11312
providing direct care to an older adult if the person has been 11313
convicted of or pleaded guilty to any of the following:11314

       (a) A violation of section 2903.01, 2903.02, 2903.03, 11315
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 11316
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,11317
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 11318
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 11319
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,11320
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 11321
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 11322
2925.22, 2925.23, or 3716.11 of the Revised Code.11323

       (b) A violation of an existing or former law of this state,11324
any other state, or the United States that is substantially 11325
equivalent to any of the offenses listed in division (C)(1)(a) of 11326
this section.11327

       (2)(a) A hospice care program may employ conditionally an11328
applicant for whom a criminal records check request is required11329
under division (B) of this section prior to obtaining the results11330
of a criminal records check regarding the individual, provided 11331
that the program shall request a criminal records check regarding 11332
the individual in accordance with division (B)(1) of this section 11333
not later than five business days after the individual begins 11334
conditional employment. In the circumstances described in 11335
division (I)(2) of this section, a hospice care program may employ11336
conditionally an applicant who has been referred to the hospice 11337
care program by an employment service that supplies full-time, 11338
part-time, or temporary staff for positions involving the direct 11339
care of older adults and for whom, pursuant to that division, a 11340
criminal records check is not required under division (B) of this 11341
section.11342

       (b) A hospice care program that employs an individual 11343
conditionally under authority of division (C)(2)(a) of this 11344
section shall terminate the individual's employment if the results11345
of the criminal records check requested under division (B) of this11346
section or described in division (I)(2) of this section, other11347
than the results of any request for information from the federal 11348
bureau of investigation, are not obtained within the period ending 11349
thirty days after the date the request is made. Regardless of when 11350
the results of the criminal records check are obtained, if the 11351
results indicate that the individual has been convicted of or 11352
pleaded guilty to any of the offenses listed or described in 11353
division (C)(1) of this section, the program shall terminate the 11354
individual's employment unless the program chooses to employ the 11355
individual pursuant to division (F) of this section. Termination 11356
of employment under this division shall be considered just cause 11357
for discharge for purposes of division (D)(2) of section 4141.29 11358
of the Revised Code if the individual makes any attempt to deceive 11359
the program about the individual's criminal record.11360

       (D)(1) Each hospice care program shall pay to the bureau of 11361
criminal identification and investigation the fee prescribed 11362
pursuant to division (C)(3) of section 109.572 of the Revised Code 11363
for each criminal records check conducted pursuant to a request 11364
made under division (B) of this section.11365

       (2) A hospice care program may charge an applicant a fee not 11366
exceeding the amount the program pays under division (D)(1) of 11367
this section. A program may collect a fee only if both of the 11368
following apply:11369

       (a) The program notifies the person at the time of initial11370
application for employment of the amount of the fee and that, 11371
unless the fee is paid, the person will not be considered for 11372
employment;11373

       (b) The medical assistancemedicaid program established under11374
Chapter 5111. of the Revised Code does not reimburse the program 11375
the fee it pays under division (D)(1) of this section.11376

       (E) The report of a criminal records check conducted pursuant 11377
to a request made under this section is not a public record for 11378
the purposes of section 149.43 of the Revised Code and shall not 11379
be made available to any person other than the following:11380

       (1) The individual who is the subject of the criminal records 11381
check or the individual's representative;11382

       (2) The chief administrator of the program requesting the 11383
criminal records check or the administrator's representative;11384

       (3) The administrator of any other facility, agency, or 11385
program that provides direct care to older adults that is owned or 11386
operated by the same entity that owns or operates the hospice care 11387
program;11388

       (4) A court, hearing officer, or other necessary individual 11389
involved in a case dealing with a denial of employment of the 11390
applicant or dealing with employment or unemployment benefits of 11391
the applicant;11392

       (5) Any person to whom the report is provided pursuant to, 11393
and in accordance with, division (I)(1) or (2) of this section.11394

       (F) The public health council shall adopt rules in accordance 11395
with Chapter 119. of the Revised Code to implement this section. 11396
The rules shall specify circumstances under which a hospice care 11397
program may employ a person who has been convicted of or pleaded11398
guilty to an offense listed or described in division (C)(1) of 11399
this section but meets personal character standards set by the 11400
council.11401

       (G) The chief administrator of a hospice care program shall 11402
inform each individual, at the time of initial application for a 11403
position that involves providing direct care to an older adult, 11404
that the individual is required to provide a set of fingerprint 11405
impressions and that a criminal records check is required to be 11406
conducted if the individual comes under final consideration for 11407
employment.11408

       (H) In a tort or other civil action for damages that is11409
brought as the result of an injury, death, or loss to person or11410
property caused by an individual who a hospice care program 11411
employs in a position that involves providing direct care to older 11412
adults, all of the following shall apply:11413

       (1) If the program employed the individual in good faith and 11414
reasonable reliance on the report of a criminal records check 11415
requested under this section, the program shall not be found 11416
negligent solely because of its reliance on the report, even if 11417
the information in the report is determined later to have been 11418
incomplete or inaccurate;11419

       (2) If the program employed the individual in good faith on a 11420
conditional basis pursuant to division (C)(2) of this section, the11421
program shall not be found negligent solely because it employed11422
the individual prior to receiving the report of a criminal records 11423
check requested under this section;11424

       (3) If the program in good faith employed the individual11425
according to the personal character standards established in rules 11426
adopted under division (F) of this section, the program shall not 11427
be found negligent solely because the individual prior to being 11428
employed had been convicted of or pleaded guilty to an offense 11429
listed or described in division (C)(1) of this section.11430

       (I)(1) The chief administrator of a hospice care program is11431
not required to request that the superintendent of the bureau of 11432
criminal identification and investigation conduct a criminal 11433
records check of an applicant if the applicant has been referred 11434
to the program by an employment service that supplies full-time, 11435
part-time, or temporary staff for positions involving the direct 11436
care of older adults and both of the following apply:11437

       (a) The chief administrator receives from the employment11438
service or the applicant a report of the results of a criminal11439
records check regarding the applicant that has been conducted by11440
the superintendent within the one-year period immediately11441
preceding the applicant's referral;11442

       (b) The report of the criminal records check demonstrates11443
that the person has not been convicted of or pleaded guilty to an 11444
offense listed or described in division (C)(1) of this section, or 11445
the report demonstrates that the person has been convicted of or 11446
pleaded guilty to one or more of those offenses, but the hospice 11447
care program chooses to employ the individual pursuant to division 11448
(F) of this section.11449

       (2) The chief administrator of a hospice care program is not 11450
required to request that the superintendent of the bureau of 11451
criminal identification and investigation conduct a criminal 11452
records check of an applicant and may employ the applicant11453
conditionally as described in this division, if the applicant has 11454
been referred to the program by an employment service that11455
supplies full-time, part-time, or temporary staff for positions11456
involving the direct care of older adults and if the chief11457
administrator receives from the employment service or the11458
applicant a letter from the employment service that is on the 11459
letterhead of the employment service, dated, and signed by a 11460
supervisor or another designated official of the employment 11461
service and that states that the employment service has requested 11462
the superintendent to conduct a criminal records check regarding 11463
the applicant, that the requested criminal records check will 11464
include a determination of whether the applicant has been 11465
convicted of or pleaded guilty to any offense listed or described 11466
in division (C)(1) of this section, that, as of the date set forth 11467
on the letter, the employment service had not received the results 11468
of the criminal records check, and that, when the employment 11469
service receives the results of the criminal records check, it 11470
promptly will send a copy of the results to the hospice care 11471
program. If a hospice care program employs an applicant 11472
conditionally in accordance with this division, the employment 11473
service, upon its receipt of the results of the criminal records 11474
check, promptly shall send a copy of the results to the hospice 11475
care program, and division (C)(2)(b) of this section applies 11476
regarding the conditional employment.11477

       Sec. 3721.01.  (A) As used in sections 3721.01 to 3721.09 and 11478
3721.99 of the Revised Code:11479

       (1)(a) "Home" means an institution, residence, or facility11480
that provides, for a period of more than twenty-four hours,11481
whether for a consideration or not, accommodations to three or11482
more unrelated individuals who are dependent upon the services of11483
others, including a nursing home, residential care facility, home11484
for the aging, and a veterans' home operated under Chapter 5907. 11485
of the Revised Code.11486

       (b) "Home" also means both of the following:11487

       (i) Any facility that a person, as defined in section 3702.51 11488
of the Revised Code, proposes for certification as a skilled 11489
nursing facility or nursing facility under Title XVIII or XIX of11490
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 11491
as amendedmedicare program, or as a nursing facility under the 11492
medicaid program and for which a certificate of need, other than a11493
certificate to recategorize hospital beds as described in section11494
3702.522 of the Revised Code or division (R)(7)(d) of the version11495
of section 3702.51 of the Revised Code in effect immediately prior11496
to April 20, 1995, has been granted to the person under sections11497
3702.51 to 3702.62 of the Revised Code after August 5, 1989;11498

       (ii) A county home or district home that is or has been11499
licensed as a residential care facility.11500

       (c) "Home" does not mean any of the following:11501

       (i) Except as provided in division (A)(1)(b) of this section, 11502
a public hospital or hospital as defined in section 3701.01 or 11503
5122.01 of the Revised Code;11504

       (ii) A residential facility for mentally ill persons as11505
defined under section 5119.22 of the Revised Code;11506

       (iii) A residential facility as defined in section 5123.19 of 11507
the Revised Code;11508

       (iv) A community alternative home as defined in section11509
3724.01 of the Revised Code;11510

       (v) An adult care facility as defined in section 3722.01 of11511
the Revised Code;11512

       (vi) An alcohol or drug addiction program as defined in11513
section 3793.01 of the Revised Code;11514

       (vii) A facility licensed to provide methadone treatment11515
under section 3793.11 of the Revised Code;11516

       (viii) A facility providing services under contract with the11517
department of mental retardation and developmental disabilities11518
under section 5123.18 of the Revised Code;11519

       (ix) A facility operated by a hospice care program licensed11520
under section 3712.04 of the Revised Code that is used exclusively11521
for care of hospice patients;11522

       (x) A facility, infirmary, or other entity that is operated11523
by a religious order, provides care exclusively to members of11524
religious orders who take vows of celibacy and live by virtue of11525
their vows within the orders as if related, and does not11526
participate in the medicare program established under Title XVIII11527
of the "Social Security Act" or the medical assistancemedicaid11528
program established under Chapter 5111. of the Revised Code and 11529
Title XIX of the "Social Security Act," if on January 1, 1994, the 11530
facility, infirmary, or entity was providing care exclusively to 11531
members of the religious order;11532

       (xi) A county home or district home that has never been11533
licensed as a residential care facility.11534

       (2) "Unrelated individual" means one who is not related to11535
the owner or operator of a home or to the spouse of the owner or11536
operator as a parent, grandparent, child, grandchild, brother,11537
sister, niece, nephew, aunt, uncle, or as the child of an aunt or11538
uncle.11539

       (3) "Mental impairment" does not mean mental illness as11540
defined in section 5122.01 of the Revised Code or mental11541
retardation as defined in section 5123.01 of the Revised Code.11542

       (4) "Skilled nursing care" means procedures that require11543
technical skills and knowledge beyond those the untrained person11544
possesses and that are commonly employed in providing for the11545
physical, mental, and emotional needs of the ill or otherwise11546
incapacitated. "Skilled nursing care" includes, but is not limited 11547
to, the following:11548

       (a) Irrigations, catheterizations, application of dressings,11549
and supervision of special diets;11550

       (b) Objective observation of changes in the patient's11551
condition as a means of analyzing and determining the nursing care11552
required and the need for further medical diagnosis and treatment;11553

       (c) Special procedures contributing to rehabilitation;11554

       (d) Administration of medication by any method ordered by a11555
physician, such as hypodermically, rectally, or orally, including11556
observation of the patient after receipt of the medication;11557

       (e) Carrying out other treatments prescribed by the physician 11558
that involve a similar level of complexity and skill in11559
administration.11560

       (5)(a) "Personal care services" means services including, but 11561
not limited to, the following:11562

       (i) Assisting residents with activities of daily living;11563

       (ii) Assisting residents with self-administration of11564
medication, in accordance with rules adopted under section 3721.0411565
of the Revised Code;11566

       (iii) Preparing special diets, other than complex therapeutic 11567
diets, for residents pursuant to the instructions of a physician 11568
or a licensed dietitian, in accordance with rules adopted under 11569
section 3721.04 of the Revised Code.11570

       (b) "Personal care services" does not include "skilled11571
nursing care" as defined in division (A)(4) of this section. A11572
facility need not provide more than one of the services listed in11573
division (A)(5)(a) of this section to be considered to be11574
providing personal care services.11575

       (6) "Nursing home" means a home used for the reception and11576
care of individuals who by reason of illness or physical or mental11577
impairment require skilled nursing care and of individuals who11578
require personal care services but not skilled nursing care. A11579
nursing home is licensed to provide personal care services and11580
skilled nursing care.11581

       (7) "Residential care facility" means a home that provides11582
either of the following:11583

       (a) Accommodations for seventeen or more unrelated11584
individuals and supervision and personal care services for three11585
or more of those individuals who are dependent on the services of11586
others by reason of age or physical or mental impairment;11587

       (b) Accommodations for three or more unrelated individuals,11588
supervision and personal care services for at least three of those11589
individuals who are dependent on the services of others by reason11590
of age or physical or mental impairment, and, to at least one of11591
those individuals, any of the skilled nursing care authorized by11592
section 3721.011 of the Revised Code.11593

       (8) "Home for the aging" means a home that provides services11594
as a residential care facility and a nursing home, except that the11595
home provides its services only to individuals who are dependent11596
on the services of others by reason of both age and physical or11597
mental impairment.11598

       The part or unit of a home for the aging that provides11599
services only as a residential care facility is licensed as a11600
residential care facility. The part or unit that may provide11601
skilled nursing care beyond the extent authorized by section11602
3721.011 of the Revised Code is licensed as a nursing home.11603

       (9) "County home" and "district home" mean a county home or11604
district home operated under Chapter 5155. of the Revised Code.11605

       (B) The public health council may further classify homes. For 11606
the purposes of this chapter, any residence, institution, hotel, 11607
congregate housing project, or similar facility that meets the 11608
definition of a home under this section is such a home regardless 11609
of how the facility holds itself out to the public.11610

       (C) For purposes of this chapter, personal care services or11611
skilled nursing care shall be considered to be provided by a11612
facility if they are provided by a person employed by or11613
associated with the facility or by another person pursuant to an11614
agreement to which neither the resident who receives the services11615
nor the resident's sponsor is a party.11616

       (D) Nothing in division (A)(4) of this section shall be11617
construed to permit skilled nursing care to be imposed on an11618
individual who does not require skilled nursing care.11619

       Nothing in division (A)(5) of this section shall be construed11620
to permit personal care services to be imposed on an individual11621
who is capable of performing the activity in question without11622
assistance.11623

       (E) Division (A)(1)(c)(x) of this section does not prohibit a 11624
facility, infirmary, or other entity described in that division11625
from seeking licensure under sections 3721.01 to 3721.09 of the11626
Revised Code or certification under Title XVIII or XIX of the11627
"Social Security Act." However, such a facility, infirmary, or11628
entity that applies for licensure or certification must meet the11629
requirements of those sections or titles and the rules adopted11630
under them and obtain a certificate of need from the director of11631
health under section 3702.52 of the Revised Code.11632

       (F) Nothing in this chapter, or rules adopted pursuant to it, 11633
shall be construed as authorizing the supervision, regulation, or 11634
control of the spiritual care or treatment of residents or11635
patients in any home who rely upon treatment by prayer or11636
spiritual means in accordance with the creed or tenets of any11637
recognized church or religious denomination.11638

       Sec. 3721.011.  (A) In addition to providing accommodations,11639
supervision, and personal care services to its residents, a11640
residential care facility may provide skilled nursing care to its 11641
residents as follows:11642

       (1) Supervision of special diets;11643

       (2) Application of dressings, in accordance with rules11644
adopted under section 3721.04 of the Revised Code;11645

       (3) Subject to division (B)(1) of this section, 11646
administration of medication;11647

       (4) Subject to division (C) of this section, other skilled 11648
nursing care provided on a part-time, intermittent basis for not 11649
more than a total of one hundred twenty days in a twelve-month 11650
period;11651

        (5) Subject to division (D) of this section, skilled nursing 11652
care provided for more than one hundred twenty days in a 11653
twelve-month period to a hospice patient, as defined in section 11654
3712.01 of the Revised Code.11655

       A residential care facility may not admit or retain an11656
individual requiring skilled nursing care that is not authorized11657
by this section. A residential care facility may not provide11658
skilled nursing care beyond the limits established by this11659
section.11660

       (B)(1) A residential care facility may admit or retain an11661
individual requiring medication, including biologicals, only if11662
the individual's personal physician has determined in writing that11663
the individual is capable of self-administering the medication or11664
the facility provides for the medication to be administered to the11665
individual by a home health agency certified under Title XVIII of11666
the "Social Security Act," 79 Stat. 620 (1965), 42 U.S.C.A. 1395,11667
as amendedmedicare program; a hospice care program licensed under11668
Chapter 3712. of the Revised Code; or a member of the staff of the 11669
residential care facility who is qualified to perform medication 11670
administration. Medication may be administered in a residential11671
care facility only by the following persons authorized by law to 11672
administer medication:11673

       (a) A registered nurse licensed under Chapter 4723. of the11674
Revised Code;11675

       (b) A licensed practical nurse licensed under Chapter 4723.11676
of the Revised Code who holds proof of successful completion of a11677
course in medication administration approved by the board of11678
nursing and who administers the medication only at the direction11679
of a registered nurse or a physician authorized under Chapter11680
4731. of the Revised Code to practice medicine and surgery or11681
osteopathic medicine and surgery;11682

       (c) A medication aide certified under Chapter 4723. of the 11683
Revised Code;11684

       (d) A physician authorized under Chapter 4731. of the Revised 11685
Code to practice medicine and surgery or osteopathic medicine and 11686
surgery.11687

       (2) In assisting a resident with self-administration of11688
medication, any member of the staff of a residential care facility11689
may do the following:11690

       (a) Remind a resident when to take medication and watch to11691
ensure that the resident follows the directions on the container;11692

       (b) Assist a resident by taking the medication from the11693
locked area where it is stored, in accordance with rules adopted11694
pursuant to section 3721.04 of the Revised Code, and handing it to11695
the resident. If the resident is physically unable to open the11696
container, a staff member may open the container for the resident.11697

       (c) Assist a physically impaired but mentally alert resident, 11698
such as a resident with arthritis, cerebral palsy, or Parkinson's 11699
disease, in removing oral or topical medication from containers 11700
and in consuming or applying the medication, upon request by or 11701
with the consent of the resident. If a resident is physically 11702
unable to place a dose of medicine to the resident's mouth without 11703
spilling it, a staff member may place the dose in a container and 11704
place the container to the mouth of the resident.11705

       (C) A residential care facility may admit or retain11706
individuals who require skilled nursing care beyond the11707
supervision of special diets, application of dressings, or11708
administration of medication, only if the care will be provided on11709
a part-time, intermittent basis for not more than a total of one11710
hundred twenty days in any twelve-month period. In accordance with 11711
Chapter 119. of the Revised Code, the public health council shall 11712
adopt rules specifying what constitutes the need for skilled11713
nursing care on a part-time, intermittent basis. The council shall 11714
adopt rules that are consistent with rules pertaining to home 11715
health care adopted by the director of job and family services11716
health care administration for the medical assistancemedicaid11717
program established under Chapter 5111. of the Revised Code. 11718
Skilled nursing care provided pursuant to this division may be11719
provided by a home health agency certified under Title XVIII of11720
the "Social Security Act,"medicare program, a hospice care 11721
program licensed under Chapter 3712. of the Revised Code, or a 11722
member of the staff of a residential care facility who is 11723
qualified to perform skilled nursing care.11724

       A residential care facility that provides skilled nursing11725
care pursuant to this division shall do both of the following:11726

       (1) Evaluate each resident receiving the skilled nursing care 11727
at least once every seven days to determine whether the resident 11728
should be transferred to a nursing home;11729

       (2) Meet the skilled nursing care needs of each resident11730
receiving the care.11731

       (D) A residential care facility may admit or retain a hospice 11732
patient who requires skilled nursing care for more than one 11733
hundred twenty days in any twelve-month period only if the 11734
facility has entered into a written agreement with a hospice care 11735
program licensed under Chapter 3712. of the Revised Code. The 11736
agreement between the residential care facility and hospice 11737
program shall include all of the following provisions:11738

        (1) That the hospice patient will be provided skilled nursing 11739
care in the facility only if a determination has been made that 11740
the patient's needs can be met at the facility;11741

        (2) That the hospice patient will be retained in the facility 11742
only if periodic redeterminations are made that the patient's 11743
needs are being met at the facility;11744

        (3) That the redeterminations will be made according to a 11745
schedule specified in the agreement;11746

        (4) That the hospice patient has been given an opportunity to 11747
choose the hospice care program that best meets the patient's 11748
needs.11749

       (E) Notwithstanding any other provision of this chapter, a11750
residential care facility in which residents receive skilled11751
nursing care pursuant to this section is not a nursing home.11752

       Sec. 3721.021.  Every person who operates a home, as defined 11753
in section 3721.01 of the Revised Code, and each county home and 11754
district home licensed as a residential care facility shall have 11755
available in the home for review by prospective patients and 11756
residents, their guardians, or other persons assisting in their 11757
placement, each inspection report completed pursuant to section 11758
3721.02 of the Revised Code and each statement of deficiencies and11759
plan of correction completed and made available to the public 11760
under Titles XVIII and XIX of the "Social Security Act," 49 Stat. 11761
620 (1935), 42 U.S.C. 301, as amendedmedicare program and 11762
medicaid program, and any rules promulgated under Titles XVIII and 11763
XIXthose programs, including such reports that result from life 11764
safety code and health inspections during the preceding three 11765
years, and shall post prominently within the home a notice of this 11766
requirement.11767

       Sec. 3721.022.  (A) As used in this section:11768

       (1) "Nursing facility" has the same meaning as in section11769
5111.205164.01 of the Revised Code.11770

       (2) "Deficiency" and "survey" have the same meanings as in11771
section 5111.355164.50 of the Revised Code.11772

       (B) The department of health is hereby designated the state11773
agency responsible for establishing and maintaining health11774
standards and serving as the state survey agency for the purposes11775
of Titles XVIII and XIX of the "Social Security Act," 49 Stat. 62011776
(1935), 42 U.S.C.A. 301, as amendedthe medicare and medicaid 11777
programs. The department shall carry out these functions in 11778
accordance with the regulations, guidelines, and procedures issued 11779
under Titles XVIII and XIXfor the medicare and medicaid programs11780
by the United States secretary of health and human services and 11781
with sections 5111.355164.50 to 5111.625164.78 of the Revised 11782
Code. The director of health shall enter into agreements with 11783
regard to these functions with the department of job and family 11784
serviceshealth care administration and the United States11785
department of health and human services. The director may also11786
enter into agreements with the department of job and family11787
serviceshealth care administration under which the department of 11788
health is designated to perform functions under sections 5111.3511789
5164.50 to 5111.625164.78 of the Revised Code.11790

       The director, in accordance with Chapter 119. of the Revised11791
Code, shall adopt rules necessary to implement the survey and11792
certification requirements for skilled nursing facilities and11793
nursing facilities established by the United States secretary of11794
health and human services under Titles XVIII and XIX of the11795
"Social Security Act,"for the medicare and medicaid programs and 11796
the survey requirements established under sections 5111.355164.5011797
to 5111.625164.78 of the Revised Code. The rules shall include an 11798
informal process by which a facility may obtain a review of 11799
deficiencies that have been cited on a statement of deficiencies 11800
made by the department of health under section 5111.425164.58 of 11801
the Revised Code. The review shall be conducted by an employee of 11802
the department who did not participate in and was not otherwise 11803
involved in any way with the survey. If the employee conducting 11804
the review determines that any deficiency citation is unjustified, 11805
that determination shall be reflected clearly in all records 11806
relating to the survey.11807

       The director need not adopt as rules any of the regulations,11808
guidelines, or procedures issued under Titles XVIII and XIX of the11809
"Social Security Act"for the medicare or medicaid programs by the 11810
United States secretary of health and human services.11811

       Sec. 3721.024.  As used in this section, "nursing facility" 11812
has the same meaning as in section 5111.205164.01 of the Revised 11813
Code.11814

       The department of health may establish a program of11815
recognition of nursing facilities that provide the highest quality 11816
care to residents who are medicaid recipients of medical 11817
assistance under Chapter 5111. of the Revised Code. The program 11818
may be funded with public funds appropriated by the general 11819
assembly for the purpose of the program or any funds appropriated 11820
for nursing home licensure.11821

       Sec. 3721.026.  (A) As used in this section and section 11822
3721.027 of the Revised Code, "nursing facility" and "survey" have 11823
the same meanings as in section 5111.355164.50 of the Revised 11824
Code.11825

       (B) The director of health shall establish a unit within the11826
department of health to provide advice and technical assistance 11827
and to conduct on-site visits to nursing facilities for the 11828
purpose of improving resident outcomes. The director shall assign 11829
to the unit employees who have training or experience in 11830
conducting or supervising surveys, but employees assigned to the 11831
unit shall not conduct surveys. The director shall adopt rules in 11832
accordance with Chapter 119. of the Revised Code to implement this 11833
section and shall consult with interested parties in developing 11834
the rules. Technical assistance reports are not public records 11835
under section 149.43 of the Revised Code and shall not be 11836
distributed to any person outside the unit except:11837

       (1) The nursing facility that is provided with the technical 11838
assistance;11839

       (2) Persons charged with inspecting nursing facilities under 11840
section 3721.02 of the Revised Code or with conducting surveys or 11841
reviews of nursing facilities under section 3721.022 of the 11842
Revised Code whenever any such person finds that there is serious11843
harm to resident health or safety that is more than isolated at 11844
the nursing facility.11845

       The provisions of this section and rules adopted under this 11846
section do not affect the department's authority to administer and 11847
enforce other sections of this chapter.11848

       (C) On or before the last day of December each year, the11849
director shall submit a report to the governor and the general 11850
assembly describing the unit's activities that year and its11851
effectiveness in improving resident outcomes.11852

       Sec. 3721.042.  The director of health may not deny a nursing 11853
home license to a facility seeking a license under this chapter as 11854
a nursing home on the grounds that the facility does not satisfy a 11855
requirement established in rules adopted under section 3721.04 of 11856
the Revised Code regarding the toilet rooms and dining and 11857
recreational areas of nursing homes if all of the following 11858
requirements are met:11859

       (A) The facility seeks a license under this chapter because 11860
it is a county home or district home being sold under section 11861
5155.31 of the Revised Code to a person who may not operate the 11862
facility without a nursing home license under this chapter.11863

       (B) The requirement would not have applied to the facility 11864
had the facility been a nursing home first licensed under this 11865
chapter before October 20, 2001.11866

       (C) The facility was a nursing facility, as defined in 11867
section 5111.205164.01 of the Revised Code, on the date 11868
immediately preceding the date the facility is sold to the person 11869
seeking the license.11870

       Sec. 3721.071.  The buildings in which a home is housed shall11871
be equipped with both an automatic fire extinguishing system and11872
fire alarm system. Such systems shall conform to standards set11873
forth in the regulations of the board of building standards and11874
the state fire marshal.11875

       The time for compliance with the requirements imposed by this11876
section shall be January 1, 1975, except that the date for11877
compliance with the automatic fire extinguishing requirements is11878
extended to January 1, 1976, provided the buildings of the home11879
are otherwise in compliance with fire safety laws and regulations11880
and:11881

       (A) The home within thirty days after August 4, 1975, files a 11882
written plan with the state fire marshal's office that:11883

       (1) Outlines the interim safety procedures which shall be11884
carried out to reduce the possibility of a fire;11885

       (2) Provides evidence that the home has entered into an11886
agreement for a fire safety inspection to be conducted not less11887
than monthly by a qualified independent safety engineer consultant11888
or a township, municipal, or other legally constituted fire11889
department, or by a township or municipal fire prevention officer;11890

       (3) Provides verification that the home has entered into a11891
valid contract for the installation of an automatic fire11892
extinguishing system or fire alarm system, or both, as required to11893
comply with this section;11894

       (4) Includes a statement regarding the expected date for the11895
completion of the fire extinguishing system or fire alarm system,11896
or both.11897

       (B) Inspections by a qualified independent safety engineer11898
consultant or a township, municipal, or other legally constituted11899
fire department, or by a township or municipal fire prevention11900
officer are initiated no later than sixty days after August 4,11901
1975, and are conducted no less than monthly thereafter, and11902
reports of the consultant, fire department, or fire prevention11903
officer identifying existing hazards and recommended corrective11904
actions are submitted to the state fire marshal, the division of11905
industrial compliance in the department of commerce, and the11906
department of health.11907

       It is the express intent of the general assembly that the11908
department of job and family serviceshealth care administration11909
shall terminate medicaid payments under Title XIX of the "Social 11910
Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended, to 11911
those homes which do not comply with the requirements of this 11912
section for the submission of a written fire safety plan and the 11913
deadline for entering into contracts for the installation of 11914
systems.11915

       Sec. 3721.08.  (A) As used in this section, "real and present 11916
danger" means imminent danger of serious physical or11917
life-threatening harm to one or more occupants of a home.11918

       (B) The director of health may petition the court of common 11919
pleas of the county in which the home is located for an order 11920
enjoining any person from operating a home without a license or 11921
enjoining a county home or district home that has had its license 11922
revoked from continuing to operate. The court shall have11923
jurisdiction to grant such injunctive relief upon a showing that 11924
the respondent named in the petition is operating a home without a 11925
license or that the county home or district home named in the 11926
petition is operating despite the revocation of its license. The 11927
court shall have jurisdiction to grant such injunctive relief 11928
against the operation of a home without a valid license regardless 11929
of whether the home meets essential licensing requirements.11930

       (C) Unless the department of job and family serviceshealth 11931
care administration or contracting agency has taken action under 11932
section 5111.515164.67 of the Revised Code to appoint a temporary 11933
manager or seek injunctive relief, if, in the judgment of the 11934
director of health, real and present danger exists at any home, 11935
the director may petition the court of common pleas of the county 11936
in which the home is located for such injunctive relief as is 11937
necessary to close the home, transfer one or more occupants to 11938
other homes or other appropriate care settings, or otherwise 11939
eliminate the real and present danger. The court shall have the 11940
jurisdiction to grant such injunctive relief upon a showing that 11941
there is real and present danger.11942

       (D)(1) If the director determines that real and present11943
danger exists at a home and elects not to immediately seek11944
injunctive relief under division (C) of this section, the director 11945
may give written notice of proposed action to the home. The notice 11946
shall specify all of the following:11947

       (a) The nature of the conditions giving rise to the real and 11948
present danger;11949

       (b) The measures that the director determines the home must 11950
take to respond to the conditions;11951

       (c) The date on which the director intends to seek injunctive 11952
relief under division (C) of this section if the director11953
determines that real and present danger exists at the home.11954

       (2) If the home notifies the director, within the time11955
specified pursuant to division (D)(1)(c) of this section, that it11956
believes the conditions giving rise to the real and present danger 11957
have been substantially corrected, the director shall conduct an 11958
inspection to determine whether real and present danger exists. If 11959
the director determines on the basis of the inspection that real 11960
and present danger exists, the director may petition under 11961
division (C) of this section for injunctive relief.11962

       (E)(1) If in the judgment of the director of health11963
conditions exist at a home that will give rise to real and present 11964
danger if not corrected, the director shall give written notice of 11965
proposed action to the home. The notice shall specify all of the 11966
following:11967

       (a) The nature of the conditions giving rise to the11968
director's judgment;11969

       (b) The measures that the director determines the home must 11970
take to respond to the conditions;11971

       (c) The date, which shall be no less than ten days after the 11972
notice is delivered, on which the director intends to seek11973
injunctive relief under division (C) of this section if the11974
conditions are not substantially corrected and the director11975
determines that a real and present danger exists.11976

       (2) If the home notifies the director, within the period of 11977
time specified pursuant to division (E)(1)(c) of this section,11978
that the conditions giving rise to the director's determination11979
have been substantially corrected, the director shall conduct an11980
inspection. If the director determines on the basis of the11981
inspection that the conditions have not been corrected and a real11982
and present danger exists, the director may petition under11983
division (C) of this section for injunctive relief.11984

       (F)(1) A court that grants injunctive relief under division 11985
(C) of this section may also appoint a special master who, subject 11986
to division (F)(2) of this section, shall have such powers and 11987
authority over the home and length of appointment as the court 11988
considers necessary. Subject to division (F)(2) of this section, 11989
the salary of a special master and any costs incurred by a special 11990
master shall be the obligation of the home.11991

       (2) No special master shall enter into any employment11992
contract on behalf of a home, or purchase with the home's funds11993
any capital goods totaling more than ten thousand dollars, unless11994
the special master has obtained approval for the contract or11995
purchase from the home's operator or the court.11996

       (G) If the director takes action under division (C), (D), or 11997
(E) of this section, the director may also appoint employees of 11998
the department of health to conduct on-site monitoring of the 11999
home. Appointment of monitors is not subject to appeal under 12000
Chapter 119. or any other section of the Revised Code. No employee 12001
of a home for which monitors are appointed, no person employed by 12002
the home within the previous two years, and no person who 12003
currently has a consulting contract with the department or a home, 12004
shall be appointed under this division. Every monitor shall have 12005
the professional qualifications necessary to monitor correction of12006
the conditions that give rise to or, in the director's judgment,12007
will give rise to real and present danger. The number of monitors 12008
present at a home at any given time shall not exceed one for every 12009
fifty residents, or fraction thereof.12010

       (H) On finding that the real and present danger for which12011
injunctive relief was granted under division (C) of this section12012
has been eliminated and that the home's operator has demonstrated12013
the capacity to prevent the real and present danger from12014
recurring, the court shall terminate its jurisdiction over the12015
home and return control and management of the home to the12016
operator. If the real and present danger cannot be eliminated12017
practicably within a reasonable time following appointment of a12018
special master, the court may order the special master to close12019
the home and transfer all residents to other homes or other12020
appropriate care settings.12021

       (I) The director of health shall give notice of proposed12022
action under divisions (D) and (E) of this section to both of the12023
following:12024

       (1) The home's administrator;12025

       (2) If the home is operated by an organization described in 12026
subsection 501(c)(3) and tax exempt under subsection 501(a) of the 12027
"Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as 12028
amended, the board of trustees of the organization; or, if the 12029
home is not operated by such an organization, the owner of the 12030
home.12031

       Notices shall be delivered by certified mail or hand12032
delivery. If notices are mailed, they shall be addressed to the12033
persons specified in divisions (I)(1) and (2) of this section, as12034
indicated in the department of health's records. If they are hand 12035
delivered, they shall be delivered to persons who would reasonably 12036
appear to the average prudent person to have authority to accept 12037
them.12038

       (J) If ownership of a home is assigned or transferred to a12039
different person, the new owner is responsible and liable for12040
compliance with any notice of proposed action or order issued12041
under this section prior to the effective date of the assignment12042
or transfer.12043

       Sec. 3721.10.  As used in sections 3721.10 to 3721.18 of the12044
Revised Code:12045

       (A) "Home" means all of the following:12046

       (1) A home as defined in section 3721.01 of the Revised Code;12047

       (2) Any facility or part of a facility not defined as a home12048
under section 3721.01 of the Revised Code that is certified as a12049
skilled nursing facility under Title XVIII of the "Social Security12050
Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395 and 1396, as amended,12051
for the medicare program or as a nursing facility as defined in 12052
section 5111.20 of the Revised Codefor the medicaid program;12053

       (3) A county home or district home operated pursuant to12054
Chapter 5155. of the Revised Code.12055

       (B) "Resident" means a resident or a patient of a home.12056

       (C) "Administrator" means all of the following:12057

       (1) With respect to a home as defined in section 3721.01 of12058
the Revised Code, a nursing home administrator as defined in12059
section 4751.01 of the Revised Code;12060

       (2) With respect to a facility or part of a facility not12061
defined as a home in section 3721.01 of the Revised Code that is12062
authorized to provide skilled nursing facility or nursing facility12063
services, the administrator of the facility or part of a facility;12064

       (3) With respect to a county home or district home, the12065
superintendent appointed under Chapter 5155. of the Revised Code.12066

       (D) "Sponsor" means an adult relative, friend, or guardian of 12067
a resident who has an interest or responsibility in the resident's 12068
welfare.12069

       (E) "Residents' rights advocate" means:12070

       (1) An employee or representative of any state or local12071
government entity that has a responsibility regarding residents12072
and that has registered with the department of health under12073
division (B) of section 3701.07 of the Revised Code;12074

       (2) An employee or representative of any private nonprofit12075
corporation or association that qualifies for tax-exempt status12076
under section 501(a) of the "Internal Revenue Code of 1986," 10012077
Stat. 2085, 26 U.S.C.A. 1, as amended, and that has registered12078
with the department of health under division (B) of section12079
3701.07 of the Revised Code and whose purposes include educating12080
and counseling residents, assisting residents in resolving12081
problems and complaints concerning their care and treatment, and12082
assisting them in securing adequate services to meet their needs;12083

       (3) A member of the general assembly.12084

       (F) "Physical restraint" means, but is not limited to, any12085
article, device, or garment that interferes with the free movement12086
of the resident and that the resident is unable to remove easily,12087
a geriatric chair, or a locked room door.12088

       (G) "Chemical restraint" means any medication bearing the12089
American hospital formulary service therapeutic class 4.00,12090
28:16:08, 28:24:08, or 28:24:92 that alters the functioning of the12091
central nervous system in a manner that limits physical and12092
cognitive functioning to the degree that the resident cannot12093
attain the resident's highest practicable physical, mental, and12094
psychosocial well-being.12095

       (H) "Ancillary service" means, but is not limited to,12096
podiatry, dental, hearing, vision, physical therapy, occupational12097
therapy, speech therapy, and psychological and social services.12098

       (I) "Facility" means a facility, or part of a facility,12099
certified as a nursing facility or skilled nursing facility under12100
Title XVIII or Title XIX of the "Social Security Act."medicare or 12101
medicaid programs. "Facility" does not include an intermediate 12102
care facility for the mentally retarded, as defined in section 12103
5111.205164.01 of the Revised Code.12104

       (J) "Medicare" means the program established by Title XVIII12105
of the "Social Security Act."12106

       (K) "Medicaid" means the program established by Title XIX of12107
the "Social Security Act" and Chapter 5111. of the Revised Code.12108

       Sec. 3721.12.  (A) The administrator of a home shall:12109

       (1) With the advice of residents, their sponsors, or both,12110
establish and review at least annually, written policies regarding12111
the applicability and implementation of residents' rights under12112
sections 3721.10 to 3721.17 of the Revised Code, the12113
responsibilities of residents regarding the rights, and the home's12114
grievance procedure established under division (A)(2) of this12115
section. The administrator is responsible for the development of,12116
and adherence to, procedures implementing the policies.12117

       (2) Establish a grievance committee for review of complaints12118
by residents. The grievance committee shall be comprised of the12119
home's staff and residents, sponsors, or outside representatives12120
in a ratio of not more than one staff member to every two12121
residents, sponsors, or outside representatives.12122

       (3) Furnish to each resident and sponsor prior to or at the12123
time of admission, and to each member of the home's staff, at12124
least one of each of the following:12125

       (a) A copy of the rights established under sections 3721.1012126
to 3721.17 of the Revised Code;12127

       (b) A written explanation of the provisions of sections12128
3721.16 to 3721.162 of the Revised Code;12129

       (c) A copy of the home's policies and procedures established12130
under this section;12131

       (d) A copy of the home's rules;12132

       (e) A copy of the addresses and telephone numbers of the12133
board of health of the health district of the county in which the12134
home is located, the county department of job and family services12135
of the county in which the home is located, the state departments12136
of health and job and family services, the state and local offices12137
of the department of aging, and any Ohio nursing home ombudsperson12138
program.12139

       (B) Written acknowledgment of the receipt of copies of the12140
materials listed in this section shall be made part of the12141
resident's record and the staff member's personnel record.12142

       (C) The administrator shall post all of the following12143
prominently within the home:12144

       (1) A copy of the rights of residents as listed in division12145
(A) of section 3721.13 of the Revised Code;12146

       (2) A copy of the home's rules and its policies and12147
procedures regarding the rights and responsibilities of residents;12148

       (3) A notice that a copy of this chapter, rules of the12149
department of health applicable to the home, and federal12150
regulations adopted under the medicare and medicaid programs, and12151
the materials required to be available in the home under section12152
3721.021 of the Revised Code, are available for inspection in the12153
home at reasonable hours;12154

       (4) A list of residents' rights advocates;12155

       (5) A notice that the following are available in a place12156
readily accessible to residents:12157

       (a) If the home is licensed under section 3721.02 of the12158
Revised Code, a copy of the most recent licensure inspection12159
report prepared for the home under that section;12160

       (b) If the home is a facility, a copy of the most recent12161
statement of deficiencies issued to the home under section 5111.4212162
5164.58 of the Revised Code.12163

       (D) The administrator of a home may, with the advice of12164
residents, their sponsors, or both, establish written policies12165
regarding the applicability and administration of any additional12166
residents' rights beyond those set forth in sections 3721.10 to12167
3721.17 of the Revised Code, and the responsibilities of residents12168
regarding the rights. Policies established under this division12169
shall be reviewed, and procedures developed and adhered to as in12170
division (A)(1) of this section.12171

       Sec. 3721.121.  (A) As used in this section:12172

       (1) "Adult day-care program" means a program operated12173
pursuant to rules adopted by the public health council under12174
section 3721.04 of the Revised Code and provided by and on the 12175
same site as homes licensed under this chapter.12176

       (2) "Applicant" means a person who is under final12177
consideration for employment with a home or adult day-care program 12178
in a full-time, part-time, or temporary position that involves 12179
providing direct care to an older adult. "Applicant" does not 12180
include a person who provides direct care as a volunteer without 12181
receiving or expecting to receive any form of remuneration other 12182
than reimbursement for actual expenses.12183

       (3) "Criminal records check" and "older adult" have the same 12184
meanings as in section 109.572 of the Revised Code.12185

       (4) "Home" means a home as defined in section 3721.10 of the 12186
Revised Code.12187

       (B)(1) Except as provided in division (I) of this section, 12188
the chief administrator of a home or adult day-care program shall 12189
request that the superintendent of the bureau of criminal 12190
identification and investigation conduct a criminal records check 12191
with respect to each applicant. If an applicant for whom a 12192
criminal records check request is required under this division 12193
does not present proof of having been a resident of this state for 12194
the five-year period immediately prior to the date the criminal 12195
records check is requested or provide evidence that within that 12196
five-year period the superintendent has requested information 12197
about the applicant from the federal bureau of investigation in a 12198
criminal records check, the chief administrator shall request that 12199
the superintendent obtain information from the federal bureau of 12200
investigation as part of the criminal records check of the 12201
applicant. Even if an applicant for whom a criminal records check 12202
request is required under this division presents proof of having12203
been a resident of this state for the five-year period, the chief12204
administrator may request that the superintendent include12205
information from the federal bureau of investigation in the12206
criminal records check.12207

       (2) A person required by division (B)(1) of this section to 12208
request a criminal records check shall do both of the following:12209

       (a) Provide to each applicant for whom a criminal records 12210
check request is required under that division a copy of the form12211
prescribed pursuant to division (C)(1) of section 109.572 of the 12212
Revised Code and a standard fingerprint impression sheet 12213
prescribed pursuant to division (C)(2) of that section, and obtain 12214
the completed form and impression sheet from the applicant;12215

       (b) Forward the completed form and impression sheet to the 12216
superintendent of the bureau of criminal identification and 12217
investigation.12218

       (3) An applicant provided the form and fingerprint impression 12219
sheet under division (B)(2)(a) of this section who fails to 12220
complete the form or provide fingerprint impressions shall not be 12221
employed in any position for which a criminal records check is 12222
required by this section.12223

       (C)(1) Except as provided in rules adopted by the director of 12224
health in accordance with division (F) of this section and subject 12225
to division (C)(2) of this section, no home or adult day-care 12226
program shall employ a person in a position that involves 12227
providing direct care to an older adult if the person has been 12228
convicted of or pleaded guilty to any of the following:12229

       (a) A violation of section 2903.01, 2903.02, 2903.03, 12230
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 12231
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,12232
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 12233
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 12234
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,12235
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 12236
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 12237
2925.22, 2925.23, or 3716.11 of the Revised Code.12238

       (b) A violation of an existing or former law of this state,12239
any other state, or the United States that is substantially 12240
equivalent to any of the offenses listed in division (C)(1)(a) of 12241
this section.12242

       (2)(a) A home or an adult day-care program may employ12243
conditionally an applicant for whom a criminal records check 12244
request is required under division (B) of this section prior to 12245
obtaining the results of a criminal records check regarding the 12246
individual, provided that the home or program shall request a 12247
criminal records check regarding the individual in accordance with 12248
division (B)(1) of this section not later than five business days 12249
after the individual begins conditional employment. In the 12250
circumstances described in division (I)(2) of this section, a home 12251
or adult day-care program may employ conditionally an applicant 12252
who has been referred to the home or adult day-care program by an12253
employment service that supplies full-time, part-time, or12254
temporary staff for positions involving the direct care of older12255
adults and for whom, pursuant to that division, a criminal records 12256
check is not required under division (B) of this section.12257

       (b) A home or adult day-care program that employs an12258
individual conditionally under authority of division (C)(2)(a) of 12259
this section shall terminate the individual's employment if the 12260
results of the criminal records check requested under division (B) 12261
of this section or described in division (I)(2) of this section, 12262
other than the results of any request for information from the 12263
federal bureau of investigation, are not obtained within the 12264
period ending thirty days after the date the request is made. 12265
Regardless of when the results of the criminal records check are 12266
obtained, if the results indicate that the individual has been 12267
convicted of or pleaded guilty to any of the offenses listed or 12268
described in division (C)(1) of this section, the home or program 12269
shall terminate the individual's employment unless the home or 12270
program chooses to employ the individual pursuant to division (F) 12271
of this section. Termination of employment under this division12272
shall be considered just cause for discharge for purposes of12273
division (D)(2) of section 4141.29 of the Revised Code if the 12274
individual makes any attempt to deceive the home or program about 12275
the individual's criminal record.12276

       (D)(1) Each home or adult day-care program shall pay to the 12277
bureau of criminal identification and investigation the fee 12278
prescribed pursuant to division (C)(3) of section 109.572 of the 12279
Revised Code for each criminal records check conducted pursuant to 12280
a request made under division (B) of this section.12281

       (2) A home or adult day-care program may charge an applicant 12282
a fee not exceeding the amount the home or program pays under 12283
division (D)(1) of this section. A home or program may collect a 12284
fee only if both of the following apply:12285

       (a) The home or program notifies the person at the time of12286
initial application for employment of the amount of the fee and 12287
that, unless the fee is paid, the person will not be considered 12288
for employment;12289

       (b) The medical assistancemedicaid program established under12290
Chapter 5111. of the Revised Code does not reimburse the home or 12291
program the fee it pays under division (D)(1) of this section.12292

       (E) The report of any criminal records check conducted 12293
pursuant to a request made under this section is not a public 12294
record for the purposes of section 149.43 of the Revised Code and 12295
shall not be made available to any person other than the 12296
following:12297

       (1) The individual who is the subject of the criminal records 12298
check or the individual's representative;12299

       (2) The chief administrator of the home or program requesting 12300
the criminal records check or the administrator's representative;12301

       (3) The administrator of any other facility, agency, or 12302
program that provides direct care to older adults that is owned or 12303
operated by the same entity that owns or operates the home or 12304
program;12305

       (4) A court, hearing officer, or other necessary individual 12306
involved in a case dealing with a denial of employment of the 12307
applicant or dealing with employment or unemployment benefits of 12308
the applicant;12309

       (5) Any person to whom the report is provided pursuant to, 12310
and in accordance with, division (I)(1) or (2) of this section;12311

       (6) The board of nursing for purposes of accepting and 12312
processing an application for a medication aide certificate issued 12313
under Chapter 4723. of the Revised Code.12314

       (F) In accordance with section 3721.11 of the Revised Code, 12315
the director of health shall adopt rules to implement this12316
section. The rules shall specify circumstances under which a home 12317
or adult day-care program may employ a person who has been12318
convicted of or pleaded guilty to an offense listed or described 12319
in division (C)(1) of this section but meets personal character 12320
standards set by the director.12321

       (G) The chief administrator of a home or adult day-care 12322
program shall inform each individual, at the time of initial 12323
application for a position that involves providing direct care to 12324
an older adult, that the individual is required to provide a set 12325
of fingerprint impressions and that a criminal records check is 12326
required to be conducted if the individual comes under final 12327
consideration for employment.12328

       (H) In a tort or other civil action for damages that is12329
brought as the result of an injury, death, or loss to person or12330
property caused by an individual who a home or adult day-care 12331
program employs in a position that involves providing direct care 12332
to older adults, all of the following shall apply:12333

       (1) If the home or program employed the individual in good12334
faith and reasonable reliance on the report of a criminal records12335
check requested under this section, the home or program shall not 12336
be found negligent solely because of its reliance on the report,12337
even if the information in the report is determined later to have 12338
been incomplete or inaccurate;12339

       (2) If the home or program employed the individual in good 12340
faith on a conditional basis pursuant to division (C)(2) of this 12341
section, the home or program shall not be found negligent solely 12342
because it employed the individual prior to receiving the report 12343
of a criminal records check requested under this section;12344

       (3) If the home or program in good faith employed the12345
individual according to the personal character standards 12346
established in rules adopted under division (F) of this section, 12347
the home or program shall not be found negligent solely because12348
the individual prior to being employed had been convicted of or12349
pleaded guilty to an offense listed or described in division12350
(C)(1) of this section.12351

       (I)(1) The chief administrator of a home or adult day-care12352
program is not required to request that the superintendent of the 12353
bureau of criminal identification and investigation conduct a 12354
criminal records check of an applicant if the applicant has been 12355
referred to the home or program by an employment service that 12356
supplies full-time, part-time, or temporary staff for positions 12357
involving the direct care of older adults and both of the 12358
following apply:12359

       (a) The chief administrator receives from the employment12360
service or the applicant a report of the results of a criminal12361
records check regarding the applicant that has been conducted by12362
the superintendent within the one-year period immediately12363
preceding the applicant's referral;12364

       (b) The report of the criminal records check demonstrates12365
that the person has not been convicted of or pleaded guilty to an 12366
offense listed or described in division (C)(1) of this section, or 12367
the report demonstrates that the person has been convicted of or 12368
pleaded guilty to one or more of those offenses, but the home or 12369
adult day-care program chooses to employ the individual pursuant 12370
to division (F) of this section.12371

       (2) The chief administrator of a home or adult day-care 12372
program is not required to request that the superintendent of the 12373
bureau of criminal identification and investigation conduct a 12374
criminal records check of an applicant and may employ the 12375
applicant conditionally as described in this division, if the 12376
applicant has been referred to the home or program by an 12377
employment service that supplies full-time, part-time, or 12378
temporary staff for positions involving the direct care of older 12379
adults and if the chief administrator receives from the employment 12380
service or the applicant a letter from the employment service that 12381
is on the letterhead of the employment service, dated, and signed 12382
by a supervisor or another designated official of the employment 12383
service and that states that the employment service has requested 12384
the superintendent to conduct a criminal records check regarding 12385
the applicant, that the requested criminal records check will 12386
include a determination of whether the applicant has been 12387
convicted of or pleaded guilty to any offense listed or described 12388
in division (C)(1) of this section, that, as of the date set forth 12389
on the letter, the employment service had not received the results 12390
of the criminal records check, and that, when the employment 12391
service receives the results of the criminal records check, it 12392
promptly will send a copy of the results to the home or adult 12393
day-care program. If a home or adult day-care program employs an12394
applicant conditionally in accordance with this division, the 12395
employment service, upon its receipt of the results of the 12396
criminal records check, promptly shall send a copy of the results 12397
to the home or adult day-care program, and division (C)(2)(b) of 12398
this section applies regarding the conditional employment.12399

       Sec. 3721.13.  (A) The rights of residents of a home shall12400
include, but are not limited to, the following:12401

       (1) The right to a safe and clean living environment pursuant 12402
to the medicare and medicaid programs and applicable state laws 12403
and regulations prescribed by the public health council;12404

       (2) The right to be free from physical, verbal, mental, and12405
emotional abuse and to be treated at all times with courtesy,12406
respect, and full recognition of dignity and individuality;12407

       (3) Upon admission and thereafter, the right to adequate and12408
appropriate medical treatment and nursing care and to other12409
ancillary services that comprise necessary and appropriate care12410
consistent with the program for which the resident contracted.12411
This care shall be provided without regard to considerations such12412
as race, color, religion, national origin, age, or source of12413
payment for care.12414

       (4) The right to have all reasonable requests and inquiries12415
responded to promptly;12416

       (5) The right to have clothes and bed sheets changed as the12417
need arises, to ensure the resident's comfort or sanitation;12418

       (6) The right to obtain from the home, upon request, the name 12419
and any specialty of any physician or other person responsible for 12420
the resident's care or for the coordination of care;12421

       (7) The right, upon request, to be assigned, within the12422
capacity of the home to make the assignment, to the staff12423
physician of the resident's choice, and the right, in accordance12424
with the rules and written policies and procedures of the home, to12425
select as the attending physician a physician who is not on the12426
staff of the home. If the cost of a physician's services is to be12427
met under a federally supported program, the physician shall meet12428
the federal laws and regulations governing such services.12429

       (8) The right to participate in decisions that affect the12430
resident's life, including the right to communicate with the12431
physician and employees of the home in planning the resident's12432
treatment or care and to obtain from the attending physician12433
complete and current information concerning medical condition,12434
prognosis, and treatment plan, in terms the resident can12435
reasonably be expected to understand; the right of access to all12436
information in the resident's medical record; and the right to12437
give or withhold informed consent for treatment after the12438
consequences of that choice have been carefully explained. When12439
the attending physician finds that it is not medically advisable12440
to give the information to the resident, the information shall be12441
made available to the resident's sponsor on the resident's behalf,12442
if the sponsor has a legal interest or is authorized by the12443
resident to receive the information. The home is not liable for a12444
violation of this division if the violation is found to be the12445
result of an act or omission on the part of a physician selected12446
by the resident who is not otherwise affiliated with the home.12447

       (9) The right to withhold payment for physician visitation if 12448
the physician did not visit the resident;12449

       (10) The right to confidential treatment of personal and12450
medical records, and the right to approve or refuse the release of12451
these records to any individual outside the home, except in case12452
of transfer to another home, hospital, or health care system, as12453
required by law or rule, or as required by a third-party payment12454
contract;12455

       (11) The right to privacy during medical examination or12456
treatment and in the care of personal or bodily needs;12457

       (12) The right to refuse, without jeopardizing access to12458
appropriate medical care, to serve as a medical research subject;12459

       (13) The right to be free from physical or chemical12460
restraints or prolonged isolation except to the minimum extent12461
necessary to protect the resident from injury to self, others, or12462
to property and except as authorized in writing by the attending12463
physician for a specified and limited period of time and12464
documented in the resident's medical record. Prior to authorizing12465
the use of a physical or chemical restraint on any resident, the12466
attending physician shall make a personal examination of the12467
resident and an individualized determination of the need to use12468
the restraint on that resident.12469

       Physical or chemical restraints or isolation may be used in12470
an emergency situation without authorization of the attending12471
physician only to protect the resident from injury to self or12472
others. Use of the physical or chemical restraints or isolation12473
shall not be continued for more than twelve hours after the onset12474
of the emergency without personal examination and authorization by12475
the attending physician. The attending physician or a staff12476
physician may authorize continued use of physical or chemical12477
restraints for a period not to exceed thirty days, and at the end12478
of this period and any subsequent period may extend the12479
authorization for an additional period of not more than thirty12480
days. The use of physical or chemical restraints shall not be12481
continued without a personal examination of the resident and the12482
written authorization of the attending physician stating the12483
reasons for continuing the restraint.12484

       If physical or chemical restraints are used under this12485
division, the home shall ensure that the restrained resident12486
receives a proper diet. In no event shall physical or chemical12487
restraints or isolation be used for punishment, incentive, or12488
convenience.12489

       (14) The right to the pharmacist of the resident's choice and 12490
the right to receive pharmaceutical supplies and services at12491
reasonable prices not exceeding applicable and normally accepted12492
prices for comparably packaged pharmaceutical supplies and12493
services within the community;12494

       (15) The right to exercise all civil rights, unless the12495
resident has been adjudicated incompetent pursuant to Chapter12496
2111. of the Revised Code and has not been restored to legal12497
capacity, as well as the right to the cooperation of the home's12498
administrator in making arrangements for the exercise of the right12499
to vote;12500

       (16) The right of access to opportunities that enable the12501
resident, at the resident's own expense or at the expense of a12502
third-party payer, to achieve the resident's fullest potential,12503
including educational, vocational, social, recreational, and12504
habilitation programs;12505

       (17) The right to consume a reasonable amount of alcoholic12506
beverages at the resident's own expense, unless not medically12507
advisable as documented in the resident's medical record by the12508
attending physician or unless contradictory to written admission12509
policies;12510

       (18) The right to use tobacco at the resident's own expense12511
under the home's safety rules and under applicable laws and rules12512
of the state, unless not medically advisable as documented in the12513
resident's medical record by the attending physician or unless12514
contradictory to written admission policies;12515

       (19) The right to retire and rise in accordance with the12516
resident's reasonable requests, if the resident does not disturb12517
others or the posted meal schedules and upon the home's request12518
remains in a supervised area, unless not medically advisable as12519
documented by the attending physician;12520

       (20) The right to observe religious obligations and12521
participate in religious activities; the right to maintain12522
individual and cultural identity; and the right to meet with and12523
participate in activities of social and community groups at the12524
resident's or the group's initiative;12525

       (21) The right upon reasonable request to private and12526
unrestricted communications with the resident's family, social12527
worker, and any other person, unless not medically advisable as12528
documented in the resident's medical record by the attending12529
physician, except that communications with public officials or12530
with the resident's attorney or physician shall not be restricted. 12531
Private and unrestricted communications shall include, but are not 12532
limited to, the right to:12533

       (a) Receive, send, and mail sealed, unopened correspondence;12534

       (b) Reasonable access to a telephone for private12535
communications;12536

       (c) Private visits at any reasonable hour.12537

       (22) The right to assured privacy for visits by the spouse,12538
or if both are residents of the same home, the right to share a12539
room within the capacity of the home, unless not medically12540
advisable as documented in the resident's medical record by the12541
attending physician;12542

       (23) The right upon reasonable request to have room doors12543
closed and to have them not opened without knocking, except in the12544
case of an emergency or unless not medically advisable as12545
documented in the resident's medical record by the attending12546
physician;12547

       (24) The right to retain and use personal clothing and a12548
reasonable amount of possessions, in a reasonably secure manner,12549
unless to do so would infringe on the rights of other residents or12550
would not be medically advisable as documented in the resident's12551
medical record by the attending physician;12552

       (25) The right to be fully informed, prior to or at the time12553
of admission and during the resident's stay, in writing, of the12554
basic rate charged by the home, of services available in the home,12555
and of any additional charges related to such services, including12556
charges for services not covered under the medicare or medicaid12557
program. The basic rate shall not be changed unless thirty days12558
notice is given to the resident or, if the resident is unable to12559
understand this information, to the resident's sponsor.12560

       (26) The right of the resident and person paying for the care 12561
to examine and receive a bill at least monthly for the resident's 12562
care from the home that itemizes charges not included in the basic 12563
rates;12564

       (27)(a) The right to be free from financial exploitation;12565

       (b) The right to manage the resident's own personal financial 12566
affairs, or, if the resident has delegated this responsibility in12567
writing to the home, to receive upon written request at least a 12568
quarterly accounting statement of financial transactions made on 12569
the resident's behalf. The statement shall include:12570

       (i) A complete record of all funds, personal property, or12571
possessions of a resident from any source whatsoever, that have12572
been deposited for safekeeping with the home for use by the12573
resident or the resident's sponsor;12574

       (ii) A listing of all deposits and withdrawals transacted,12575
which shall be substantiated by receipts which shall be available12576
for inspection and copying by the resident or sponsor.12577

       (28) The right of the resident to be allowed unrestricted12578
access to the resident's property on deposit at reasonable hours,12579
unless requests for access to property on deposit are so12580
persistent, continuous, and unreasonable that they constitute a12581
nuisance;12582

       (29) The right to receive reasonable notice before the12583
resident's room or roommate is changed, including an explanation12584
of the reason for either change.12585

       (30) The right not to be transferred or discharged from the12586
home unless the transfer is necessary because of one of the12587
following:12588

       (a) The welfare and needs of the resident cannot be met in12589
the home.12590

       (b) The resident's health has improved sufficiently so that12591
the resident no longer needs the services provided by the home.12592

       (c) The safety of individuals in the home is endangered.12593

       (d) The health of individuals in the home would otherwise be12594
endangered.12595

       (e) The resident has failed, after reasonable and appropriate 12596
notice, to pay or to have the medicare or medicaid program pay on 12597
the resident's behalf, for the care provided by the home. A 12598
resident shall not be considered to have failed to have the 12599
resident's care paid for if the resident has applied for medicaid, 12600
unless both of the following are the case:12601

       (i) The resident's application, or a substantially similar12602
previous application, has been denied by the county department of12603
job and family services.12604

       (ii) If the resident appealed the denial pursuant to division 12605
(C) of section 5101.355160.34 of the Revised Code, the director12606
of job and family services has upheld the denial.12607

       (f) The home's license has been revoked, the home is being12608
closed pursuant to section 3721.08, sections 5111.355164.50 to 12609
5111.625164.78, or section 5155.31 of the Revised Code, or the 12610
home otherwise ceases to operate.12611

       (g) The resident is a recipient of medicaid, and the home's12612
participation in the medicaid program is involuntarily terminated12613
or denied.12614

       (h) The resident is a beneficiary under the medicare program, 12615
and the home's participation in the medicare program is12616
involuntarily terminated or denied.12617

       (31) The right to voice grievances and recommend changes in12618
policies and services to the home's staff, to employees of the12619
department of health, or to other persons not associated with the12620
operation of the home, of the resident's choice, free from12621
restraint, interference, coercion, discrimination, or reprisal.12622
This right includes access to a residents' rights advocate, and12623
the right to be a member of, to be active in, and to associate12624
with persons who are active in organizations of relatives and12625
friends of nursing home residents and other organizations engaged12626
in assisting residents.12627

       (32) The right to have any significant change in the12628
resident's health status reported to the resident's sponsor. As12629
soon as such a change is known to the home's staff, the home shall12630
make a reasonable effort to notify the sponsor within twelve12631
hours.12632

       (B) A sponsor may act on a resident's behalf to assure that12633
the home does not deny the residents' rights under sections12634
3721.10 to 3721.17 of the Revised Code.12635

       (C) Any attempted waiver of the rights listed in division (A) 12636
of this section is void.12637

       Sec. 3721.15.  (A) Authorization from a resident or a sponsor 12638
with a power of attorney for a home to manage the resident's 12639
financial affairs shall be in writing and shall be attested to by 12640
a witness who is not connected in any manner whatsoever with the 12641
home or its administrator. The home shall maintain accounts 12642
pursuant to division (A)(27) of section 3721.13 of the Revised 12643
Code. Upon the resident's transfer, discharge, or death, the 12644
account shall be closed and a final accounting made. All remaining 12645
funds shall be returned to the resident or resident's sponsor, 12646
except in the case of death, when all remaining funds shall be 12647
transferred or used in accordance with section 5111.1135162.37 of 12648
the Revised Code.12649

       (B) A home that manages a resident's financial affairs shall12650
deposit the resident's funds in excess of one hundred dollars, and12651
may deposit the resident's funds that are one hundred dollars or12652
less, in an interest-bearing account separate from any of the12653
home's operating accounts. Interest earned on the resident's funds 12654
shall be credited to the resident's account. A resident's funds 12655
that are one hundred dollars or less and have not been deposited12656
in an interest-bearing account may be deposited in a12657
noninterest-bearing account or petty cash fund.12658

       (C) Each resident whose financial affairs are managed by a12659
home shall be promptly notified by the home when the total of the12660
amount of funds in the resident's accounts and the petty cash fund12661
plus other nonexempt resources reaches two hundred dollars less12662
than the maximum amount permitted a recipient of medicaid. The12663
notice shall include an explanation of the potential effect on the12664
resident's eligibility for medicaid if the amount in the12665
resident's accounts and the petty cash fund, plus the value of12666
other nonexempt resources, exceeds the maximum assets a medicaid12667
recipient may retain.12668

       (D) Each home that manages the financial affairs of residents 12669
shall purchase a surety bond or otherwise provide assurance 12670
satisfactory to the director of health, or, in the case of a home 12671
that participates in the medicaid program, to the director of job 12672
and family serviceshealth care administration, to assure the 12673
security of all residents' funds managed by the home.12674

       Sec. 3721.16. For each resident of a home, notice of a12675
proposed transfer or discharge shall be in accordance with this12676
section.12677

       (A)(1) The administrator of a home shall notify a resident in 12678
writing, and the resident's sponsor in writing by certified mail, 12679
return receipt requested, in advance of any proposed transfer or12680
discharge from the home. The administrator shall send a copy of 12681
the notice to the state department of health. The notice shall be 12682
provided at least thirty days in advance of the proposed transfer 12683
or discharge, unless any of the following applies:12684

       (a) The resident's health has improved sufficiently to allow12685
a more immediate discharge or transfer to a less skilled level of12686
care;12687

       (b) The resident has resided in the home less than thirty12688
days;12689

       (c) An emergency arises in which the safety of individuals in 12690
the home is endangered;12691

       (d) An emergency arises in which the health of individuals in 12692
the home would otherwise be endangered;12693

       (e) An emergency arises in which the resident's urgent12694
medical needs necessitate a more immediate transfer or discharge.12695

       In any of the circumstances described in divisions (A)(1)(a) 12696
to (e) of this section, the notice shall be provided as many days12697
in advance of the proposed transfer or discharge as is12698
practicable.12699

       (2) The notice required under division (A)(1) of this section 12700
shall include all of the following:12701

       (a) The reasons for the proposed transfer or discharge;12702

       (b) The proposed date the resident is to be transferred or12703
discharged;12704

       (c) The proposed location to which the resident is to be12705
transferred or discharged;12706

       (d) Notice of the right of the resident and the resident's12707
sponsor to an impartial hearing at the home on the proposed12708
transfer or discharge, and of the manner in which and the time12709
within which the resident or sponsor may request a hearing 12710
pursuant to section 3721.161 of the Revised Code;12711

       (e) A statement that the resident will not be transferred or12712
discharged before the date specified in the notice unless the home12713
and the resident or, if the resident is not competent to make a12714
decision, the home and the resident's sponsor, agree to an earlier12715
date;12716

       (f) The address of the legal services office of the12717
department of health;12718

       (g) The name, address, and telephone number of a12719
representative of the state long-term care ombudsperson program12720
and, if the resident or patient has a developmental disability or12721
mental illness, the name, address, and telephone number of the12722
Ohio legal rights service.12723

       (B) No home shall transfer or discharge a resident before the12724
date specified in the notice required by division (A) of this12725
section unless the home and the resident or, if the resident is12726
not competent to make a decision, the home and the resident's12727
sponsor, agree to an earlier date.12728

       (C) Transfer or discharge actions shall be documented in the12729
resident's medical record by the home if there is a medical basis12730
for the action.12731

       (D) A resident or resident's sponsor may challenge a transfer 12732
or discharge by requesting an impartial hearing pursuant to 12733
section 3721.161 of the Revised Code, unless the transfer or12734
discharge is required because of one of the following reasons:12735

       (1) The home's license has been revoked under this chapter;12736

       (2) The home is being closed pursuant to section 3721.08,12737
sections 5111.35 to 5111.62, or section 5155.31, or sections 12738
5164.50 to 5164.78 of the Revised Code;12739

       (3) The resident is a recipient of medicaid and the home's12740
participation in the medicaid program has been involuntarily12741
terminated or denied by the federal government;12742

       (4) The resident is a beneficiary under the medicare program 12743
and the home's certification under the medicare program has been12744
involuntarily terminated or denied by the federal government.12745

       (E) If a resident is transferred or discharged pursuant to12746
this section, the home from which the resident is being12747
transferred or discharged shall provide the resident with adequate12748
preparation prior to the transfer or discharge to ensure a safe12749
and orderly transfer or discharge from the home, and the home or12750
alternative setting to which the resident is to be transferred or12751
discharged shall have accepted the resident for transfer or12752
discharge.12753

       (F) At the time of a transfer or discharge of a resident who12754
is a recipient of medicaid from a home to a hospital or for12755
therapeutic leave, the home shall provide notice in writing to the12756
resident and in writing by certified mail, return receipt12757
requested, to the resident's sponsor, specifying the number of12758
days, if any, during which the resident will be permitted under12759
the medicaid program to return and resume residence in the home12760
and specifying the medicaid program's coverage of the days during12761
which the resident is absent from the home. An individual who is12762
absent from a home for more than the number of days specified in12763
the notice and continues to require the services provided by the12764
facility shall be given priority for the first available bed in a12765
semi-private room.12766

       Sec. 3721.17.  (A) Any resident who believes that the12767
resident's rights under sections 3721.10 to 3721.17 of the Revised12768
Code have been violated may file a grievance under procedures12769
adopted pursuant to division (A)(2) of section 3721.12 of the12770
Revised Code.12771

       When the grievance committee determines a violation of12772
sections 3721.10 to 3721.17 of the Revised Code has occurred, it12773
shall notify the administrator of the home. If the violation12774
cannot be corrected within ten days, or if ten days have elapsed12775
without correction of the violation, the grievance committee shall12776
refer the matter to the department of health.12777

       (B) Any person who believes that a resident's rights under12778
sections 3721.10 to 3721.17 of the Revised Code have been violated12779
may report or cause reports to be made of the information directly12780
to the department of health. No person who files a report is12781
liable for civil damages resulting from the report.12782

       (C)(1) Within thirty days of receiving a complaint under this 12783
section, the department of health shall investigate any complaint 12784
referred to it by a home's grievance committee and any complaint 12785
from any source that alleges that the home provided substantially 12786
less than adequate care or treatment, or substantially unsafe 12787
conditions, or, within seven days of receiving a complaint, refer 12788
it to the attorney general, if the attorney general agrees to 12789
investigate within thirty days.12790

       (2) Within thirty days of receiving a complaint under this12791
section, the department of health may investigate any alleged12792
violation of sections 3721.10 to 3721.17 of the Revised Code, or12793
of rules, policies, or procedures adopted pursuant to those12794
sections, not covered by division (C)(1) of this section, or it12795
may, within seven days of receiving a complaint, refer the12796
complaint to the grievance committee at the home where the alleged12797
violation occurred, or to the attorney general if the attorney12798
general agrees to investigate within thirty days.12799

       (D) If, after an investigation, the department of health12800
finds probable cause to believe that a violation of sections12801
3721.10 to 3721.17 of the Revised Code, or of rules, policies, or12802
procedures adopted pursuant to those sections, has occurred at a12803
home that is certified under the medicare or medicaid program, it12804
shall cite one or more findings or deficiencies under sections12805
5111.355164.50 to 5111.625164.78 of the Revised Code. If the 12806
home is not so certified, the department shall hold an 12807
adjudicative hearing within thirty days under Chapter 119. of the 12808
Revised Code.12809

       (E) Upon a finding at an adjudicative hearing under division12810
(D) of this section that a violation of sections 3721.10 to12811
3721.17 of the Revised Code, or of rules, policies, or procedures12812
adopted pursuant thereto, has occurred, the department of health12813
shall make an order for compliance, set a reasonable time for12814
compliance, and assess a fine pursuant to division (F) of this12815
section. The fine shall be paid to the general revenue fund only12816
if compliance with the order is not shown to have been made within12817
the reasonable time set in the order. The department of health may 12818
issue an order prohibiting the continuation of any violation of 12819
sections 3721.10 to 3721.17 of the Revised Code.12820

       Findings at the hearings conducted under this section may be12821
appealed pursuant to Chapter 119. of the Revised Code, except that12822
an appeal may be made to the court of common pleas of the county12823
in which the home is located.12824

       The department of health shall initiate proceedings in court12825
to collect any fine assessed under this section that is unpaid12826
thirty days after the violator's final appeal is exhausted.12827

       (F) Any home found, pursuant to an adjudication hearing under 12828
division (D) of this section, to have violated sections 3721.10 to 12829
3721.17 of the Revised Code, or rules, policies, or procedures 12830
adopted pursuant to those sections may be fined not less than one 12831
hundred nor more than five hundred dollars for a first offense. 12832
For each subsequent offense, the home may be fined not less than 12833
two hundred nor more than one thousand dollars.12834

       A violation of sections 3721.10 to 3721.17 of the Revised12835
Code is a separate offense for each day of the violation and for12836
each resident who claims the violation.12837

       (G) No home or employee of a home shall retaliate against any 12838
person who:12839

       (1) Exercises any right set forth in sections 3721.10 to12840
3721.17 of the Revised Code, including, but not limited to, filing12841
a complaint with the home's grievance committee or reporting an12842
alleged violation to the department of health;12843

       (2) Appears as a witness in any hearing conducted under this12844
section or section 3721.162 of the Revised Code;12845

       (3) Files a civil action alleging a violation of sections12846
3721.10 to 3721.17 of the Revised Code, or notifies a county12847
prosecuting attorney or the attorney general of a possible12848
violation of sections 3721.10 to 3721.17 of the Revised Code.12849

       If, under the procedures outlined in this section, a home or12850
its employee is found to have retaliated, the violator may be12851
fined up to one thousand dollars.12852

       (H) When legal action is indicated, any evidence of criminal12853
activity found in an investigation under division (C) of this12854
section shall be given to the prosecuting attorney in the county12855
in which the home is located for investigation.12856

       (I)(1)(a) Any resident whose rights under sections 3721.10 to12857
3721.17 of the Revised Code are violated has a cause of action12858
against any person or home committing the violation.12859

       (b) An action under division (I)(1)(a) of this section may be 12860
commenced by the resident or by the resident's legal guardian or 12861
other legally authorized representative on behalf of the resident 12862
or the resident's estate. If the resident or the resident's legal 12863
guardian or other legally authorized representative is unable to 12864
commence an action under that division on behalf of the resident, 12865
the following persons in the following order of priority have the 12866
right to and may commence an action under that division on behalf 12867
of the resident or the resident's estate:12868

       (i) The resident's spouse;12869

       (ii) The resident's parent or adult child;12870

       (iii) The resident's guardian if the resident is a minor12871
child;12872

       (iv) The resident's brother or sister;12873

       (v) The resident's niece, nephew, aunt, or uncle.12874

       (c) Notwithstanding any law as to priority of persons12875
entitled to commence an action, if more than one eligible person12876
within the same level of priority seeks to commence an action on12877
behalf of a resident or the resident's estate, the court shall12878
determine, in the best interest of the resident or the resident's12879
estate, the individual to commence the action. A court's12880
determination under this division as to the person to commence an12881
action on behalf of a resident or the resident's estate shall bar12882
another person from commencing the action on behalf of the12883
resident or the resident's estate.12884

       (d) The result of an action commenced pursuant to division12885
(I)(1)(a) of this section by a person authorized under division12886
(I)(1)(b) of this section shall bind the resident or the12887
resident's estate that is the subject of the action.12888

       (e) A cause of action under division (I)(1)(a) of this12889
section shall accrue, and the statute of limitations applicable to12890
that cause of action shall begin to run, based upon the violation12891
of a resident's rights under sections 3721.10 to 3721.17 of the12892
Revised Code, regardless of the party commencing the action on12893
behalf of the resident or the resident's estate as authorized12894
under divisions (I)(1)(b) and (c) of this section.12895

       (2)(a) The plaintiff in an action filed under division (I)(1)12896
of this section may obtain injunctive relief against the violation12897
of the resident's rights. The plaintiff also may recover12898
compensatory damages based upon a showing, by a preponderance of12899
the evidence, that the violation of the resident's rights resulted12900
from a negligent act or omission of the person or home and that12901
the violation was the proximate cause of the resident's injury,12902
death, or loss to person or property.12903

       (b) If compensatory damages are awarded for a violation of12904
the resident's rights, section 2315.21 of the Revised Code shall12905
apply to an award of punitive or exemplary damages for the12906
violation.12907

       (c) The court, in a case in which only injunctive relief is12908
granted, may award to the prevailing party reasonable attorney's12909
fees limited to the work reasonably performed.12910

       (3) Division (I)(2) (b) of this section shall be considered12911
to be purely remedial in operation and shall be applied in a12912
remedial manner in any civil action in which this section is12913
relevant, whether the action is pending in court or commenced on12914
or after July 9, 1998.12915

       (4) Within thirty days after the filing of a complaint in an12916
action for damages brought against a home under division (I)(1)(a)12917
of this section by or on behalf of a resident or former resident12918
of the home, the plaintiff or plaintiff's counsel shall send12919
written notice of the filing of the complaint to the department of12920
job and family services if the department has a right of recovery12921
under section 5101.585160.38 of the Revised Code against the 12922
liability of the home for the cost of medical services and care 12923
arising out of injury, disease, or disability of the resident or 12924
former resident.12925

       Sec. 3721.19.  (A) As used in this section:12926

       (1) "Home" and "residential care facility" have the same12927
meanings as in section 3721.01 of the Revised Code;12928

       (2) "Sponsor" and "residents' rights advocate" have the same12929
meanings as in section 3721.10 of the Revised Code.12930

       A home licensed under this chapter that is not a party to a12931
provider agreement, as defined in section 5111.205164.01 of the 12932
Revised Code, shall provide each prospective resident, before 12933
admission, with the following information, orally and in a 12934
separate written notice on which is printed in a conspicuous 12935
manner: "This home is not a participant in the medical assistance12936
medicaid program administered by the Ohio department of job and 12937
family serviceshealth care administration. Consequently, you may 12938
be discharged from this home if you are unable to pay for the 12939
services provided by this home."12940

       If the prospective resident has a sponsor whose identity is12941
made known to the home, the home shall also inform the sponsor,12942
before admission of the resident, of the home's status relative to12943
the medical assistancemedicaid program. Written acknowledgement12944
acknowledgment of the receipt of the information shall be provided 12945
by the resident and, if the prospective resident has a sponsor who 12946
has been identified to the home, by the sponsor. The written 12947
acknowledgementacknowledgment shall be made part of the 12948
resident's record by the home.12949

       No home shall terminate its status as a provider under the 12950
medicaid program unless it has complied with section 5111.6612951
5164.83 of the Revised Code and, at least ninety days prior to 12952
such termination, provided written notice to the residents of the 12953
home and their sponsors of such action. This requirement shall not12954
apply in cases where the department of job and family services12955
health care administration terminates a home's provider agreement 12956
or provider status.12957

       (B) A home licensed under this chapter as a residential care12958
facility shall provide notice to each prospective resident or the12959
individual's sponsor of the services offered by the facility and12960
the types of skilled nursing care that the facility may provide. A 12961
residential care facility that, pursuant to section 3721.012 of12962
the Revised Code, has a policy of entering into risk agreements12963
with residents or their sponsors shall provide each prospective12964
resident or the individual's sponsor a written explanation of the12965
policy and the provisions that may be contained in a risk12966
agreement. At the time the information is provided, the facility12967
shall obtain a statement signed by the individual receiving the12968
information acknowledging that the individual received the12969
information. The facility shall maintain on file the individual's12970
signed statement.12971

       (C) A resident has a cause of action against a home for12972
breach of any duty imposed by this section. The action may be12973
commenced by the resident, or on the resident's behalf by the12974
resident's sponsor or a residents' rights advocate, by the filing12975
of a civil action in the court of common pleas of the county in12976
which the home is located, or in the court of common pleas of12977
Franklin county.12978

       If the court finds that a breach of any duty imposed by this12979
section has occurred, the court shall enjoin the home from12980
discharging the resident from the home until arrangements12981
satisfactory to the court are made for the orderly transfer of the12982
resident to another mode of health care including, but not limited12983
to, another home, and may award the resident and a person or12984
public agency that brings an action on behalf of a resident12985
reasonable attorney's fees. If a home discharges a resident to12986
whom or to whose sponsor information concerning its status12987
relative to the medical assistancemedicaid program was not 12988
provided as required under this section, the court shall grant any12989
appropriate relief including, but not limited to, actual damages,12990
reasonable attorney's fees, and costs.12991

       Sec. 3721.21.  As used in sections 3721.21 to 3721.34 of the 12992
Revised Code:12993

       (A) "Long-term care facility" means either of the following:12994

       (1) A nursing home as defined in section 3721.01 of the12995
Revised Code, other than a nursing home or part of a nursing home12996
certified as an intermediate care facility for the mentally12997
retarded under Title XIX of the "Social Security Act," 49 Stat.12998
620 (1935), 42 U.S.C.A. 301, as amendedmedicaid program;12999

       (2) A facility or part of a facility that is certified as a 13000
skilled nursing facility or a nursing facility under Title XVIII 13001
or XIX of the "Social Security Actmedicare program and medicaid 13002
program."13003

       (B) "Residential care facility" has the same meaning as in 13004
section 3721.01 of the Revised Code.13005

       (C) "Abuse" means knowingly causing physical harm or13006
recklessly causing serious physical harm to a resident by physical 13007
contact with the resident or by use of physical or chemical 13008
restraint, medication, or isolation as punishment, for staff 13009
convenience, excessively, as a substitute for treatment, or in 13010
amounts that preclude habilitation and treatment.13011

       (D) "Neglect" means recklessly failing to provide a resident 13012
with any treatment, care, goods, or service necessary to maintain 13013
the health or safety of the resident when the failure results in 13014
serious physical harm to the resident. "Neglect" does not include 13015
allowing a resident, at the resident's option, to receive only13016
treatment by spiritual means through prayer in accordance with the 13017
tenets of a recognized religious denomination.13018

       (E) "Misappropriation" means depriving, defrauding, or13019
otherwise obtaining the real or personal property of a resident by 13020
any means prohibited by the Revised Code, including violations of 13021
Chapter 2911. or 2913. of the Revised Code.13022

       (F) "Resident" includes a resident, patient, former resident 13023
or patient, or deceased resident or patient of a long-term care 13024
facility or a residential care facility.13025

       (G) "Physical restraint" has the same meaning as in section 13026
3721.10 of the Revised Code.13027

       (H) "Chemical restraint" has the same meaning as in section 13028
3721.10 of the Revised Code.13029

       (I) "Nursing and nursing-related services" means the personal 13030
care services and other services not constituting skilled nursing 13031
care that are specified in rules the public health council shall 13032
adopt in accordance with Chapter 119. of the Revised Code.13033

       (J) "Personal care services" has the same meaning as in13034
section 3721.01 of the Revised Code.13035

       (K)(1) Except as provided in division (K)(2) of this section, 13036
"nurse aide" means an individual who provides nursing and 13037
nursing-related services to residents in a long-term care 13038
facility, either as a member of the staff of the facility for 13039
monetary compensation or as a volunteer without monetary 13040
compensation.13041

       (2) "Nurse aide" does not include either of the following:13042

        (a) A licensed health professional practicing within the 13043
scope of the professional's license;13044

        (b) An individual providing nursing and nursing-related 13045
services in a religious nonmedical health care institution, if the 13046
individual has been trained in the principles of nonmedical care 13047
and is recognized by the institution as being competent in the 13048
administration of care within the religious tenets practiced by 13049
the residents of the institution.13050

       (L) "Licensed health professional" means all of the13051
following:13052

       (1) An occupational therapist or occupational therapy13053
assistant licensed under Chapter 4755. of the Revised Code;13054

       (2) A physical therapist or physical therapy assistant13055
licensed under Chapter 4755. of the Revised Code;13056

       (3) A physician authorized under Chapter 4731. of the Revised 13057
Code to practice medicine and surgery, osteopathic medicine and13058
surgery, or podiatry;13059

       (4) A physician assistant authorized under Chapter 4730. of 13060
the Revised Code to practice as a physician assistant;13061

       (5) A registered nurse or licensed practical nurse licensed 13062
under Chapter 4723. of the Revised Code;13063

       (6) A social worker or independent social worker licensed 13064
under Chapter 4757. of the Revised Code or a social work assistant13065
registered under that chapter;13066

       (7) A speech-language pathologist or audiologist licensed 13067
under Chapter 4753. of the Revised Code;13068

       (8) A dentist or dental hygienist licensed under Chapter13069
4715. of the Revised Code;13070

       (9) An optometrist licensed under Chapter 4725. of the13071
Revised Code;13072

       (10) A pharmacist licensed under Chapter 4729. of the Revised 13073
Code;13074

       (11) A psychologist licensed under Chapter 4732. of the13075
Revised Code;13076

       (12) A chiropractor licensed under Chapter 4734. of the13077
Revised Code;13078

       (13) A nursing home administrator licensed or temporarily13079
licensed under Chapter 4751. of the Revised Code;13080

       (14) A professional counselor or professional clinical 13081
counselor licensed under Chapter 4757. of the Revised Code.13082

       (M) "Religious nonmedical health care institution" means an 13083
institution that meets or exceeds the conditions to receive 13084
payment under the medicare program established under Title XVIII 13085
of the "Social Security Act" for inpatient hospital services or 13086
post-hospital extended care services furnished to an individual in 13087
a religious nonmedical health care institution, as defined in 13088
section 1861(ss)(1) of the "Social Security Act," 79 Stat. 286 13089
(1965), 42 U.S.C. 1395x(ss)(1), as amended.13090

       (N) "Competency evaluation program" means a program through 13091
which the competency of a nurse aide to provide nursing and13092
nursing-related services is evaluated.13093

       (O) "Training and competency evaluation program" means a13094
program of nurse aide training and evaluation of competency to13095
provide nursing and nursing-related services.13096

       Sec. 3721.28.  (A)(1) Each nurse aide used by a long-term13097
care facility on a full-time, temporary, per diem, or other basis13098
on July 1, 1989, shall be provided by the facility a competency13099
evaluation program approved by the director of health under13100
division (A) of section 3721.31 of the Revised Code or conducted13101
by himthe director under division (C) of that section. Each13102
long-term care facility using a nurse aide on July 1, 1989, shall 13103
provide the nurse aide the preparation necessary to complete the 13104
competency evaluation program by January 1, 1990.13105

       (2) Each nurse aide used by a long-term care facility on a13106
full-time, temporary, per diem, or other basis on January 1, 1990, 13107
who either was not used by the facility on July 1, 1989, or was 13108
used by the facility on July 1, 1989, but had not successfully 13109
completed a competency evaluation program by January 1, 1990, 13110
shall be provided by the facility a competency evaluation program 13111
approved by the director under division (A) of section 3721.31 of 13112
the Revised Code or conducted by himthe director under division 13113
(C) of that section. Each long-term care facility using a nurse 13114
aide described in division (A)(2) of this section shall provide 13115
the nurse aide the preparation necessary to complete the13116
competency evaluation program by October 1, 1990, and shall assist 13117
the nurse aide in registering for the program.13118

       (B) Effective June 1, 1990, no long-term care facility shall 13119
use an individual as a nurse aide for more than four months unless 13120
the individual is competent to provide the services hethe13121
individual is to provide, the facility has received from the nurse 13122
aide registry established under section 3721.32 of the Revised 13123
Code the information concerning the individual provided through 13124
the registry, and one of the following is the case:13125

       (1) The individual was used by a facility as a nurse aide on 13126
a full-time, temporary, per diem, or other basis at any time13127
during the period commencing July 1, 1989, and ending January 1,13128
1990, and successfully completed, not later than October 1, 1990,13129
a competency evaluation program approved by the director under13130
division (A) of section 3721.31 of the Revised Code or conducted13131
by himthe director under division (C) of that section.13132

       (2) The individual has successfully completed a training and 13133
competency evaluation program approved by the director under13134
division (A) of section 3721.31 of the Revised Code or conducted13135
by himthe director under division (C) of that section or has met 13136
the conditions specified in division (F) of this section and, in13137
addition, if the training and competency evaluation program or the 13138
training, instruction, or education the individual completed in 13139
meeting the conditions specified in division (F) of this section 13140
was conducted by or in a long-term care facility, or if the 13141
director pursuant to division (E) of section 3721.31 of the13142
Revised Code so requires, the individual has successfully13143
completed a competency evaluation program conducted by the13144
director.13145

       (3) Prior to July 1, 1989, if the long-term care facility is 13146
certified as a skilled nursing facility or a nursing facility13147
under Title XVIII or XIX of the "Social Security Act," 49 Stat.13148
620 (1935), 42 U.S.C.A. 301, as amendedmedicare program or 13149
medicaid program, or prior to January 1, 1990, if the facility is 13150
not so certified, the individual completed a program that the 13151
director determines included a competency evaluation component no 13152
less stringent than the competency evaluation programs approved by 13153
himthe director under division (A) of section 3721.31 of the 13154
Revised Code or conducted by himthe director under division (C) 13155
of that section, and was otherwise comparable to the training and 13156
competency evaluation programs being approved by the director 13157
under division (A) of that section.13158

       (4) The individual is listed in a nurse aide registry13159
maintained by another state and that state certifies that its13160
program for training and evaluation of competency of nurse aides13161
complies with Titles XVIII and XIX of the "Social Security Act"13162
medicare program and medicaid program and regulations adopted 13163
thereunder.13164

       (5) Prior to July 1, 1989, the individual was found competent 13165
to serve as a nurse aide after the completion of a course of nurse 13166
aide training of at least one hundred hours' duration.13167

       (6) The individual is enrolled in a prelicensure program of 13168
nursing education approved by the board of nursing or by an agency 13169
of another state that regulates nursing education, has provided 13170
the long-term care facility with a certificate from the program 13171
indicating that the individual has successfully completed the 13172
courses that teach basic nursing skills including infection13173
control, safety and emergency procedures, and personal care, and13174
has successfully completed a competency evaluation program13175
conducted by the director under division (C) of section 3721.31 of 13176
the Revised Code.13177

       (7) The individual has the equivalent of twelve months or13178
more of full-time employment in the preceding five years as a13179
hospital aide or orderly and has successfully completed a13180
competency evaluation program conducted by the director under13181
division (C) of section 3721.31 of the Revised Code.13182

       (C) Effective June 1, 1990, no long-term care facility shall 13183
continue for longer than four months to use as a nurse aide an 13184
individual who previously met the requirements of division (B) of 13185
this section but since most recently doing so has not performed 13186
nursing and nursing-related services for monetary compensation for 13187
twenty-four consecutive months, unless the individual successfully 13188
completes additional training and competency evaluation by 13189
complying with divisions (C)(1) and (2) of this section:13190

       (1) Doing one of the following:13191

       (a) Successfully completing a training and competency13192
evaluation program approved by the director under division (A) of13193
section 3721.31 of the Revised Code or conducted by himthe13194
director under division (C) of that section;13195

       (b) Successfully completing a training and competency13196
evaluation program described in division (B)(4) of this section;13197

       (c) Meeting the requirements specified in division (B)(6) or 13198
(7) of this section.13199

       (2) If the training and competency evaluation program13200
completed under division (C)(1)(a) of this section was conducted13201
by or in a long-term care facility, or if the director pursuant to 13202
division (E) of section 3721.31 of the Revised Code so requires, 13203
successfully completing a competency evaluation program conducted 13204
by the director.13205

       (D)(1) The four-month periods provided for in divisions (B) 13206
and (C) of this section include any time, on or after June 1,13207
1990, that an individual is used as a nurse aide on a full-time,13208
temporary, per diem, or any other basis by the facility or any13209
other long-term care facility.13210

       (2) During the four-month period provided for in division (B) 13211
of this section, during which a long-term care facility may,13212
subject to division (E) of this section, use as a nurse aide an13213
individual who does not have the qualifications specified in13214
divisions (B)(1) to (7) of this section, a facility shall require13215
the individual to comply with divisions (D)(2)(a) and (b) of this13216
section:13217

       (a) Participate in one of the following:13218

       (i) If the individual has successfully completed a training 13219
and competency evaluation program approved by the director under 13220
division (A) of section 3721.31 of the Revised Code, and the 13221
program was conducted by or in a long-term care facility, or the 13222
director pursuant to division (E) of section 3721.31 of the 13223
Revised Code so requires, a competency evaluation program 13224
conducted by the director;13225

       (ii) If the individual is enrolled in a prelicensure program 13226
of nursing education described in division (B)(6) of this section 13227
and has completed or is working toward completion of the courses 13228
described in that division, or the individual has the experience 13229
described in division (B)(7) of this section, a competency 13230
evaluation program conducted by the director;13231

       (iii) A training and competency evaluation program approved 13232
by the director under division (A) of section 3721.31 of the 13233
Revised Code or conducted by himthe director under division (C) 13234
of that section.13235

       (b) If the individual participates in or has successfully13236
completed a training and competency evaluation program under13237
division (D)(2)(a)(iii) of this section that is conducted by or in 13238
a long-term care facility, or the director pursuant to division 13239
(E) of section 3721.31 of the Revised Code so requires, paticipate13240
participate in a competency evaluation program conducted by the 13241
director.13242

       (3) During the four-month period provided for in division (C) 13243
of this section, during which a long-term care facility may,13244
subject to division (E) of this section, use as a nurse aide an13245
individual who does not have the qualifications specified in13246
divisions (C)(1) and (2) of this section, a facility shall require 13247
the individual to comply with divisions (D)(3)(a) and (b) of this 13248
section:13249

       (a) Participate in one of the following:13250

       (i) If the individual has successfully completed a training 13251
and competency evaluation program approved by the director, and 13252
the program was conducted by or in a long-term care facility, or 13253
the director pursuant to division (E) of section 3721.31 of the 13254
Revised Code so requires, a competency evaluation program 13255
conducted by the director;13256

       (ii) If the individual is enrolled in a prelicensure program 13257
of nursing education described in division (B)(6) of this section 13258
and has completed or is working toward completion of the courses 13259
described in that division, or the individual has the experience 13260
described in division (B)(7) of this section, a competency 13261
evaluation program conducted by the director;13262

       (iii) A training and competency evaluation program approved 13263
or conducted by the director.13264

       (b) If the individual participates in or has successfully13265
completed a training and competency evaluation program under13266
division (D)(3)(a)(iii) of this section that is conducted by or in 13267
a long-term care facility, or the director pursuant to division 13268
(E) of section 3721.31 of the Revised Code so requires,13269
participate in a competency evaluation program conducted by the13270
director.13271

       (E) A long-term care facility shall not permit an individual 13272
used by the facility as a nurse aide while participating in a 13273
training and competency evaluation program to provide nursing and 13274
nursing-related services unless both of the following are the 13275
case:13276

       (1) The individual has completed the number of hours of13277
training that he must completebe completed prior to providing 13278
services to residents as prescribed by rules that shall be adopted 13279
by the director in accordance with Chapter 119. of the Revised 13280
Code;13281

       (2) The individual is under the personal supervision of a13282
registered or licensed practical nurse licensed under Chapter13283
4723. of the Revised Code.13284

       (F) An individual shall be considered to have satisfied the 13285
requirement, under division (B)(2) of this section, of having13286
successfully completed a training and competency evaluation13287
program conducted or approved by the director, if the individual13288
meets both of the following conditions:13289

       (1) The individual, as of July 1, 1989, completed at least13290
sixty hours divided between skills training and classroom13291
instruction in the topic areas described in divisions (B)(1) to13292
(8) of section 3721.30 of the Revised Code;13293

       (2) The individual received, as of that date, at least the13294
difference between seventy-five hours and the number of hours13295
actually spent in training and competency evaluation in supervised 13296
practical nurse aide training or regular in-service nurse aide 13297
education.13298

       (G) The public health council shall adopt rules in accordance 13299
with Chapter 119. of the Revised Code specifying persons, in 13300
addition to the director, who may establish competence of nurse 13301
aides under division (B)(5) of this section, and establishing 13302
criteria for determining whether an individual meets the 13303
conditions specified in division (F) of this section.13304

       (H) The rules adopted pursuant to divisions (E)(1) and (G) of 13305
this section shall be no less stringent than the requirements,13306
guidelines, and procedures established by the United States13307
secretary of health and human services under sections 1819 and13308
1919 of the "Social Security Act."13309

       Sec. 3721.32.  (A) The director of health shall establish a 13310
state nurse aide registry listing all individuals who have done13311
any of the following:13312

       (1) Were used by a long-term care facility as nurse aides on 13313
a full-time, temporary, per diem, or other basis at any time13314
during the period commencing July 1, 1989, and ending January 1,13315
1990, and successfully completed, not later than October 1, 1990,13316
a competency evaluation program approved by the director under13317
division (A) of section 3721.31 of the Revised Code or conducted13318
by the director under division (C) of that section;13319

       (2) Successfully completed a training and competency13320
evaluation program approved by the director under division (A) of13321
section 3721.31 of the Revised Code or met the conditions13322
specified in division (F) of section 3721.28 of the Revised Code,13323
and, if the training and competency evaluation program or the13324
training, instruction, or education the individual completed in13325
meeting the conditions specified in division (F) of section13326
3721.28 of the Revised Code was conducted in or by a long-term13327
care facility, or if the director so required pursuant to division 13328
(E) of section 3721.31 of the Revised Code, has successfully 13329
completed a competency evaluation program conducted by the 13330
director;13331

       (3) Successfully completed a training and competency13332
evaluation program conducted by the director under division (C) of 13333
section 3721.31 of the Revised Code;13334

       (4) Successfully completed, prior to July 1, 1989, a program 13335
that the director has determined under division (B)(3) of section 13336
3721.28 of the Revised Code included a competency evaluation 13337
component no less stringent than the competency evaluation 13338
programs approved or conducted by the director under section 13339
3721.31 of the Revised Code, and was otherwise comparable to the13340
training and competency evaluation program being approved by the 13341
director under section 3721.31 of the Revised Code;13342

       (5) Are listed in a nurse aide registry maintained by another 13343
state that certifies that its program for training and evaluation 13344
of competency of nurse aides complies with Titles XVIII and XIX of13345
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 13346
as amendedmedicare program and medicaid program, or regulations 13347
adopted thereunder;13348

       (6) Were found competent, as provided in division (B)(5) of 13349
section 3721.28 of the Revised Code, prior to July 1, 1989, after 13350
the completion of a course of nurse aide training of at least one 13351
hundred hours' duration;13352

       (7) Are enrolled in a prelicensure program of nursing13353
education approved by the board of nursing or by an agency of13354
another state that regulates nursing education, have provided the13355
long-term care facility with a certificate from the program13356
indicating that the individual has successfully completed the13357
courses that teach basic nursing skills including infection13358
control, safety and emergency procedures, and personal care, and13359
have successfully completed a competency evaluation program13360
conducted by the director under division (A) of section 3721.31 of 13361
the Revised Code;13362

       (8) Have the equivalent of twelve months or more of full-time 13363
employment in the five years preceding listing in the registry as 13364
a hospital aide or orderly and have successfully completed a 13365
competency evaluation program conducted by the director under 13366
division (C) of section 3721.31 of the Revised Code.13367

       (B) The registry shall include both of the following:13368

       (1) The statement required by section 3721.23 of the Revised 13369
Code detailing findings by the director under that section 13370
regarding alleged abuse or neglect of a resident or13371
misappropriation of resident property;13372

       (2) Any statement provided by an individual under section13373
3721.23 of the Revised Code disputing the director's findings.13374

       Whenever an inquiry is received as to the information13375
contained in the registry concerning an individual about whom a13376
statement required by section 3721.23 of the Revised Code is13377
included in the registry, the director shall disclose the 13378
statement or a summary of the statement together with any 13379
statement provided by the individual under section 3721.23 or a 13380
clear and accurate summary of that statement.13381

       (C) The director may by rule specify additional information 13382
that must be provided the registry by long-term care facilities 13383
and persons or government agencies conducting approved competency 13384
evaluation programs and training and competency evaluation 13385
programs.13386

       (D) Information contained in the registry is a public record 13387
for the purposes of section 149.43 of the Revised Code, and is 13388
subject to inspection and copying under section 1347.08 of the 13389
Revised Code.13390

       Sec. 3722.10.  (A) The public health council shall have the 13391
exclusive authority to adopt and shall adopt rules in accordance 13392
with Chapter 119. of the Revised Code governing the licensing and 13393
operation of adult care facilities. The rules shall specify:13394

       (1) Procedures for the issuance, renewal, and revocation of 13395
licenses and temporary licenses, for the granting and denial of 13396
waivers, and for the issuance and termination of orders of13397
suspension of admission pursuant to section 3722.07 of the Revised 13398
Code;13399

       (2) The qualifications required for owners, managers, and13400
employees of adult care facilities, including character, training, 13401
education, experience, and financial resources and the number of 13402
staff members required in a facility;13403

       (3) Adequate space, equipment, safety, and sanitation13404
standards for the premises of adult care facilities, and fire13405
protection standards for adult family homes as required by section 13406
3722.041 of the Revised Code;13407

       (4) The personal, social, dietary, and recreational services 13408
to be provided to each resident of adult care facilities;13409

       (5) Rights of residents of adult care facilities, in addition 13410
to the rights enumerated under section 3722.12 of the Revised 13411
Code, and procedures to protect and enforce the rights of these 13412
residents;13413

       (6) Provisions for keeping records of residents and for13414
maintaining the confidentiality of the records as required by13415
division (B) of section 3722.12 of the Revised Code. The13416
provisions for maintaining the confidentiality of records shall,13417
at the minimum, meet the requirements for maintaining the13418
confidentiality of records under Title XIX of the Social Security 13419
Act, 49 Stat. 620, 42 U.S.C. 301, as amendedmedicaid program, and13420
regulations promulgated thereunder.13421

       (7) Measures to be taken by adult care facilities relative to 13422
residents' medication, including policies and procedures13423
concerning medication, storage of medication in a locked area, and 13424
disposal of medication and assistance with self-administration of 13425
medication, if the facility provides assistance;13426

       (8) Requirements for initial and periodic health assessments 13427
of prospective and current adult care facility residents by 13428
physicians or other health professionals to ensure that they do 13429
not require a level of care beyond that which is provided by the 13430
adult care facility, including assessment of their capacity to 13431
self-administer the medications prescribed for them;13432

       (9) Requirements relating to preparation of special diets;13433

       (10) The amount of the fees for new and renewal license13434
applications made pursuant to sections 3722.02 and 3722.04 of the13435
Revised Code;13436

       (11) Measures to be taken by any employee of the state or any 13437
political subdivision of the state authorized by this chapter to 13438
enter an adult care facility to inspect the facility or for any 13439
other purpose, to ensure that the employee respects the privacy 13440
and dignity of residents of the facility, cooperates with13441
residents of the facility and behaves in a congenial manner toward 13442
them, and protects the rights of residents;13443

       (12) How an owner or manager of an adult care facility is to 13444
comply with section 3722.18 of the Revised Code. The rules shall 13445
do at least both of the following:13446

       (a) Establish the procedures an owner or manager is to follow13447
under division (A)(2) of section 3722.18 of the Revised Code 13448
regarding referrals to the facility of prospective residents with 13449
mental illness or severe mental disability and effective 13450
arrangements for ongoing mental health services for such 13451
prospective residents. The procedures may provide for any of the13452
following:13453

       (i) That the owner or manager sign written agreements with 13454
the mental health agencies and boards of alcohol, drug addiction, 13455
and mental health services that refer such prospective residents 13456
to the facility. Each agreement shall cover all such prospective 13457
residents referred by the agency or board with which the owner or 13458
manager enters into the agreement.13459

       (ii) That the owner or manager and the mental health agencies 13460
and boards of alcohol, drug addiction, and mental health services 13461
that refer such prospective residents to the facility develop and 13462
sign a plan for services for each such prospective resident;13463

       (iii) Any other process regarding referrals and effective13464
arrangements for ongoing mental health services.13465

       (b) Specify the date an owner or manager must begin to follow 13466
the procedures established by division (A)(12)(a) of this section.13467

       (13) Any other rules necessary for the administration and13468
enforcement of this chapter.13469

       (B) After consulting with relevant constituencies, the13470
director of mental health shall prepare and submit to the director 13471
of health recommendations for the content of rules to be adopted 13472
under division (A)(12) of this section. The public health council 13473
shall adopt the rules required by division (A)(12) of this section 13474
no later than July 1, 2000.13475

       (C) The director of health shall advise adult care facilities 13476
regarding compliance with the requirements of this chapter and 13477
with the rules adopted pursuant to this chapter.13478

       (D) Any duty or responsibility imposed upon the director of 13479
health by this chapter may be carried out by an employee of the 13480
department of health.13481

       (E) Employees of the department of health may enter, for the 13482
purposes of investigation, any institution, residence, facility, 13483
or other structure which has been reported to the department as, 13484
or that the department has reasonable cause to believe is, 13485
operating as an adult care facility without a valid license.13486

       Sec. 3722.16.  (A) No person shall:13487

       (1) Operate an adult care facility unless the facility is13488
validly licensed by the director of health under section 3722.0413489
of the Revised Code;13490

       (2) Admit to an adult care facility more residents than the13491
number authorized in the facility's license;13492

       (3) Admit a resident to an adult care facility after the13493
director has issued an order pursuant to section 3722.07 of the13494
Revised Code suspending admissions to the facility. Violation of13495
division (A)(3) of this section is cause for revocation of the13496
facility's license.13497

       (4) Interfere with any authorized inspection of an adult care 13498
facility conducted pursuant to section 3722.02 or 3722.04 of the 13499
Revised Code;13500

       (5) Violate any of the provisions of this chapter or any of13501
the rules adopted pursuant to it.13502

       (B) No adult care facility shall provide, or admit or retain13503
any resident in need of, skilled nursing care unless all of the13504
following are the case:13505

       (1) The care will be provided on a part-time, intermittent13506
basis for not more than a total of one hundred twenty days in any13507
twelve-month period by one or more of the following:13508

       (a) A home health agency certified under Title XVIII of the13509
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as13510
amended:medicare program;13511

       (b) A hospice care program licensed under Chapter 3712. of13512
the Revised Code;13513

       (c) A nursing home licensed under Chapter 3721. of the13514
Revised Code and owned and operated by the same person and located13515
on the same site as the adult care facility;13516

       (d) A mental health agency or, pursuant to division (A)(8)(b) 13517
of section 340.03 of the Revised Code, a board of alcohol, drug 13518
addiction, and mental health services.13519

       (2) The staff of the home health agency, hospice care13520
program, nursing home, mental health agency, or board of alcohol,13521
drug addiction, and mental health services does not train facility13522
staff to provide the skilled nursing care;13523

       (3) The individual to whom the skilled nursing care is13524
provided is suffering from a short-term illness;13525

       (4) If the skilled nursing care is to be provided by the13526
nursing staff of a nursing home, all of the following are the13527
case:13528

       (a) The adult care facility evaluates the individual13529
receiving the skilled nursing care at least once every seven days13530
to determine whether the individual should be transferred to a13531
nursing home;13532

       (b) The adult care facility meets at all times staffing13533
requirements established by rules adopted under section 3722.10 of13534
the Revised Code;13535

       (c) The nursing home does not include the cost of providing13536
skilled nursing care to the adult care facility residents in a13537
cost report filed under section 5111.265164.37 of the Revised 13538
Code;13539

       (d) The nursing home meets at all times the nursing home13540
licensure staffing ratios established by rules adopted under13541
section 3721.04 of the Revised Code;13542

       (e) The nursing home staff providing skilled nursing care to13543
adult care facility residents are registered nurses or licensed13544
practical nurses licensed under Chapter 4723. of the Revised Code13545
and meet the personnel qualifications for nursing home staff13546
established by rules adopted under section 3721.04 of the Revised13547
Code;13548

       (f) The skilled nursing care is provided in accordance with13549
rules established for nursing homes under section 3721.04 of the13550
Revised Code;13551

       (g) The nursing home meets the skilled nursing care needs of13552
the adult care facility residents;13553

       (h) Using the nursing home's nursing staff does not prevent13554
the nursing home or adult care facility from meeting the needs of13555
the nursing home and adult care facility residents in a quality13556
and timely manner.13557

       Notwithstanding section 3721.01 of the Revised Code, an adult13558
care facility in which residents receive skilled nursing care as13559
described in division (B) of this section is not a nursing home.13560
No adult care facility shall provide skilled nursing care.13561

       (C) A home health agency or hospice care program that13562
provides skilled nursing care pursuant to division (B) of this13563
section may not be associated with the adult care facility unless13564
the facility is part of a home for the aged as defined in section13565
5701.13 of the Revised Code or the adult care facility is owned13566
and operated by the same person and located on the same site as a13567
nursing home licensed under Chapter 3721. of the Revised Code that13568
is associated with the home health agency or hospice care program.13569
In addition, the following requirements shall be met:13570

       (1) The adult care facility shall evaluate the individual13571
receiving the skilled nursing care not less than once every seven13572
days to determine whether the individual should be transferred to13573
a nursing home;13574

       (2) If the costs of providing the skilled nursing care are13575
included in a cost report filed pursuant to section 5111.2613576
5164.37 of the Revised Code by the nursing home that is part of 13577
the same home for the aged, the home health agency or hospice care 13578
program shall not seek reimbursement for the care under the 13579
medical assistancemedicaid program established under Chapter 13580
5111. of the Revised Code.13581

       (D)(1) No person knowingly shall place or recommend placement 13582
of any person in an adult care facility that is operating without 13583
a license.13584

       (2) No employee of a unit of local or state government, board 13585
of alcohol, drug addiction, and mental health services, mental 13586
health agency, or PASSPORT administrative agency shall place or 13587
recommend placement of any person in an adult care facility if the 13588
employee knows that the facility cannot meet the needs of the 13589
potential resident.13590

       (3) No person who has reason to believe that an adult care13591
facility is operating without a license shall fail to report this13592
information to the director of health.13593

       (E) In accordance with Chapter 119. of the Revised Code, the13594
public health council shall adopt rules that define a short-term13595
illness for purposes of division (B)(3) of this section and13596
specify, consistent with rules pertaining to home health care13597
adopted by the director of job and family serviceshealth care 13598
administration under the medical assistancemedicaid program 13599
established under Chapter 5111. of the Revised Code and Title XIX 13600
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, 13601
as amended, what constitutes a part-time, intermittent basis for 13602
purposes of division (B)(1) of this section.13603

       Sec. 3727.02.  (A) No person and no political subdivision, 13604
agency, or instrumentality of this state shall operate a hospital 13605
unless it is certified under Title XVIII offor the "Social 13606
Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended,13607
medicare program or is accredited by the joint commission or the 13608
American osteopathic association. 13609

       (B) No person and no political subdivision, agency, or 13610
instrumentality of this state shall hold out as a hospital any 13611
health facility that is not certified or accredited as required in 13612
division (A) of this section. 13613

       Sec. 3742.30. Each child at risk of lead poisoning shall13614
undergo a blood lead screening test to determine whether the child13615
has lead poisoning. The at-risk children shall undergo the test at 13616
times determined by rules the public health council shall adopt in13617
accordance with Chapter 119. of the Revised Code that are13618
consistent with the guidelines established by the centers for13619
disease control and prevention in the public health service of the13620
United States department of health and human services. The rules13621
shall specify which children are at risk of lead poisoning.13622

       Neither this section nor the rules adopted under it affect13623
the coverage of blood lead screening tests by any publicly funded13624
health program, including the medicaid program established by13625
Chapter 5111. of the Revised Code. Neither this section nor the13626
rules adopted under it apply to a child if a parent of the child13627
objects to the test on the grounds that the test conflicts with13628
the parent's religious tenets and practices.13629

       Sec. 3742.51. (A) There is hereby created in the state13630
treasury the lead poisoning prevention fund. The fund shall13631
include all moneys appropriated to the department of health for13632
the administration and enforcement of sections 3742.31 to 3742.5013633
of the Revised Code and the rules adopted under those sections.13634
Any grants, contributions, or other moneys collected by the13635
department for purposes of preventing lead poisoning shall be13636
deposited in the state treasury to the credit of the fund.13637

       (B) Moneys in the fund shall be used solely for the purposes13638
of the child lead poisoning prevention program established under13639
section 3742.31 of the Revised Code, including providing financial13640
assistance to individuals who are unable to pay for the following:13641

       (1) Costs associated with obtaining lead tests and lead13642
poisoning treatment for children under six years of age who are13643
not covered by private medical insurance or are underinsured, are13644
not eligible for the medicaid program established under Chapter13645
5111. of the Revised Code or any other government health program,13646
and do not have access to another source of funds to cover the13647
cost of lead tests and any indicated treatments;13648

       (2) Costs associated with having lead abatement performed or13649
having the preventive treatments specified in section 3742.41 of13650
the Revised Code performed.13651

       Sec. 3793.07. (A) As used in this section:13652

       (1) "Medicare program" means the program established under13653
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 4213654
U.S.C. 301, as amended;13655

       (2) "Medicaid program" means the program established under13656
Title XIX of the "Social Security Act."13657

       (B)(A) Except as provided in division (D)(C) of this section,13658
the department of alcohol and drug addiction services shall13659
establish and administer a process for the certification or13660
credentialing of chemical dependency counselors and alcohol and 13661
other drug prevention specialists for the purpose of qualifying 13662
their services for reimbursement under the medicare or medicaid13663
program. The process shall be made available to any individual who 13664
is a member of the profession of drug abuse counseling or chemical 13665
dependency counseling or any individual who is an alcohol and13666
other drug prevention specialist. Nothing in this section shall be13667
construed as requiring such certification or credentials for13668
services that are not reimbursed by medicare or medicaid.13669

       The department shall cease to administer its process for the13670
certification or credentialing of chemical dependency counselors13671
and alcohol and other drug prevention specialists under this13672
section at the earlier of the following:13673

       (1) The date, which shall be specified in an agreement13674
between the department and chemical dependency professionals13675
board, on which the board is to assume, under Chapter 4758. of the13676
Revised Code, the department's certification duties;13677

       (2) Two years after the effective date of this amendment13678
December 23, 2002.13679

       (C)(B) The department shall adopt rules in accordance with13680
Chapter 119. of the Revised Code establishing standards and13681
procedures for the certification or credentialing process. The13682
rules shall include the following:13683

       (1) Eligibility requirements;13684

       (2) Application procedures;13685

       (3) Minimum educational and clinical training requirements13686
that must be met for initial certification or credentialing;13687

       (4) Continuing education and training requirements for13688
certified or credentialed individuals;13689

       (5) Application and renewal fees that do not exceed the cost13690
incurred by the department in implementing and administering the13691
process;13692

       (6) Administration or approval of examinations;13693

       (7) Investigation of complaints and alleged violations of13694
this section;13695

       (8) Maintenance of the confidentiality of the department's13696
investigative records;13697

       (9) Disciplinary actions, including application denial and13698
suspension or revocation of certification or credentials;13699

       (10) Any other rules the department considers necessary to13700
establish or administer the certification or credentialing13701
process.13702

       (D)(C)(1) Except as provided in division (D)(C)(2) of this 13703
section, the department shall not issue an initial certificate or13704
credential to practice as a chemical dependency counselor I, but13705
may renew such a certificate or credential issued prior to the13706
effective date of this amendmentDecember 23, 2002, or pursuant to 13707
division (D)(C)(2) of this section until the department ceases to13708
administer the certification and credentialing process under this 13709
section.13710

       (2) The department may issue an initial certificate or13711
credential to practice as a chemical dependency counselor I to an13712
individual if the individual submitted the application for13713
certification or credentials to the department prior to the13714
effective date of this amendmentDecember 23, 2002.13715

       (E)(D) The department shall investigate alleged violations of13716
this section or the rules adopted under it. As part of its13717
investigation, the department may issue subpoenas, examine13718
witnesses, and administer oaths. The department shall ensure that13719
all records it holds pertaining to an investigation remain13720
confidential.13721

       (F)(E) With respect to hearings conducted by the department13722
as part of the certification or credentialing process, both of the13723
following apply:13724

       (1) An individual whose application for certification or13725
credentials issued under this section has been denied by the13726
department may request a hearing in accordance with Chapter 119.13727
of the Revised Code and the rules adopted under this section.13728

       (2) The department may appoint a referee or hearing examiner13729
to conduct the proceedings and make recommendations to the13730
department as appropriate.13731

       (G)(F) The department shall maintain a record of all fees13732
collected under this section. All fees collected shall be paid13733
into the state treasury to the credit of the credentialing fund,13734
which is hereby created. Money credited to the fund shall be used13735
solely to pay the costs of establishing and administering the13736
process for certification or credentialing of chemical dependency13737
professionals under this section.13738

       Money credited to the credentialing fund under this section 13739
shall be transferred to the occupational licensing and regulatory 13740
fund created under section 4743.05 of the Revised Code at the 13741
earlier of the following:13742

       (1) The date, which shall be specified in an agreement13743
between the department and chemical dependency professionals13744
board, on which the board is to assume, under Chapter 4758. of the13745
Revised Code, the department's certification duties;13746

       (2) Two years after the effective date of this amendment13747
December 23, 2002.13748

       (H)(G) Certifications made and credentials issued by the Ohio13749
credentialing board for chemical dependency professionals prior to13750
the date the department establishes its certification or13751
credentialing process under this section shall continue to be13752
accepted by the department until, with respect to any particular13753
individual, one of the following occurs:13754

       (1) The individual's certification or credentials from the13755
board have expired.13756

       (2) The individual's certification or credentials from the13757
board would be suspended or revoked by the department if the13758
certification or credentials had been issued by the department13759
under this section.13760

       Sec. 3901.3814. Sections 3901.38 and 3901.381 to 3901.3813 of 13761
the Revised Code do not apply to the following:13762

       (A) Policies offering coverage that is regulated under13763
Chapters 3935. and 3937. of the Revised Code;13764

       (B) An employer's self-insurance plan and any of its13765
administrators, as defined in section 3959.01 of the Revised Code,13766
to the extent that federal law supersedes, preempts, prohibits, or13767
otherwise precludes the application of any provisions of those13768
sections to the plan and its administrators;13769

       (C) A third-party payer for coverage provided under the13770
medicare advantage program operated under Title XVIII of the 13771
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as 13772
amendedmedicare program;13773

       (D) A third-party payer for coverage provided under the 13774
medicaid program operated under Title XIX of the "Social Security 13775
Act," except that if a federal waiver applied for under section 13776
5111.1785165.16 of the Revised Code is granted or the director of 13777
job and family serviceshealth care administration determines 13778
that this provision can be implemented without a waiver, sections 13779
3901.38 and 3901.381 to 3901.3813 of the Revised Code apply to 13780
claims submitted electronically or non-electronically that are 13781
made with respect to coverage of medicaid recipients by health 13782
insuring corporations licensed under Chapter 1751. of the Revised 13783
Code, instead of the prompt payment requirements of 42 C.F.R. 13784
447.46;13785

       (E) A third-party payer for coverage provided under the13786
tricare program offered by the United States department of13787
defense.13788

       (F) A third-party payer for coverage provided under the 13789
children's buy-in program established under sections 5101.5211 to 13790
5101.5216 of the Revised Code.13791

       Sec. 3903.14.  (A) The superintendent of insurance as13792
rehabilitator may appoint one or more special deputies, who shall13793
have all the powers and responsibilities of the rehabilitator13794
granted under this section, and the superintendent may employ such 13795
clerks and assistants as considered necessary. The compensation of 13796
the special deputies, clerks, and assistants and all expenses of 13797
taking possession of the insurer and of conducting the proceedings 13798
shall be fixed by the superintendent, with the approval of the 13799
court and shall be paid out of the funds or assets of the insurer. 13800
The persons appointed under this section shall serve at the 13801
pleasure of the superintendent. In the event that the property of 13802
the insurer does not contain sufficient cash or liquid assets to 13803
defray the costs incurred, the superintendent may advance the 13804
costs so incurred out of any appropriation for the maintenance of 13805
the department of insurance. Any amounts so advanced for expenses 13806
of administration shall be repaid to the superintendent for the 13807
use of the department out of the first available money of the 13808
insurer.13809

       (B) The rehabilitator may take such action as the13810
rehabilitator considers necessary or appropriate to reform and 13811
revitalize the insurer. The rehabilitator shall have all the 13812
powers of the directors, officers, and managers, whose authority 13813
shall be suspended, except as they are redelegated by the 13814
rehabilitator. The rehabilitator shall have full power to direct 13815
and manage, to hire and discharge employees subject to any 13816
contract rights they may have, and to deal with the property and13817
business of the insurer.13818

       (C) If it appears to the rehabilitator that there has been13819
criminal or tortious conduct, or breach of any contractual or13820
fiduciary obligation detrimental to the insurer by any officer,13821
manager, agent, director, trustee, broker, employee, or other13822
person, the rehabilitator may pursue all appropriate legal13823
remedies on behalf of the insurer.13824

       (D) If the rehabilitator determines that reorganization,13825
consolidation, conversion, reinsurance, merger, or other13826
transformation of the insurer is appropriate, the rehabilitator 13827
shall prepare a plan to effect such changes. Upon application of 13828
the rehabilitator for approval of the plan, and after such notice 13829
and hearings as the court may prescribe, the court may either 13830
approve or disapprove the plan proposed, or may modify it and 13831
approve it as modified. Any plan approved under this section shall 13832
be, in the judgment of the court, fair and equitable to all 13833
parties concerned. If the plan is approved, the rehabilitator 13834
shall carry out the plan. In the case of a life insurer, the plan13835
proposed may include the imposition of liens upon the policies of13836
the company, if all rights of shareholders are first relinquished. 13837
A plan for a life insurer may also propose imposition of a 13838
moratorium upon loan and cash surrender rights under policies, for 13839
such period and to such an extent as may be necessary.13840

       (E) In the case of a medicaid health insuring corporation 13841
that has posted a bond or deposited securities in accordance with 13842
section 1751.271 of the Revised Code, the plan proposed under 13843
division (D) of this section may include the use of the proceeds 13844
of the bond or securities to first pay the claims of contracted 13845
providers for covered health care services provided to medicaid 13846
recipients, then next to pay other claimants with any remaining 13847
funds, consistent with the priorities set forth in sections 13848
3903.421 and 3903.42 of the Revised Code.13849

       (F) The rehabilitator shall have the power under sections13850
3903.26 and 3903.27 of the Revised Code to avoid fraudulent13851
transfers.13852

       (G) As used in this section:13853

        (1) "Contracted provider" means a provider with a contract 13854
with a medicaid health insuring corporation to provide covered 13855
health care services to medicaid recipients.13856

        (2) "Medicaid recipient" means a person eligible for 13857
assistance under the medicaid program operated pursuant to Chapter 13858
5111. of the Revised Code.13859

       Sec. 3916.06.  (A)(1) With each application for a viatical13860
settlement, a viatical settlement provider or viatical settlement13861
broker shall disclose at least the following to a viator no later13862
than the time all parties sign the application for the viatical13863
settlement contract:13864

       (a) That there are possible alternatives to viatical13865
settlement contracts, including any accelerated death benefits13866
offered under the viator's policy;13867

       (b) That some or all of the proceeds of the viatical13868
settlement may be subject to federal income taxation and state13869
franchise and income taxation, and that assistance should be13870
sought from a professional tax advisor;13871

       (c) That the proceeds of the viatical settlement could be13872
subject to the claims of creditors;13873

       (d) That receipt of the proceeds of the viatical settlement13874
may adversely affect the viator's eligibility for medical13875
assistance under Chapter 5111. of the Revised Codethe medicaid 13876
program or other government benefits or entitlements, and that 13877
advice should be obtained from the appropriate government 13878
agencies;13879

       (e) That the viator has a right to rescind the viatical13880
settlement contract for at least fifteen calendar days after the13881
viator receives the viatical settlement proceeds, as provided in13882
section 3916.08 of the Revised Code. If the insured dies during13883
the rescission period, the viatical settlement contract shall be 13884
deemed to have been rescinded, subject to repayment of all 13885
viatical settlement proceeds to the viatical settlement company.13886

       (f) That funds will be sent to the viator within three13887
business days after the viatical settlement provider has received13888
written acknowledgment from the insurer or group administrator 13889
that ownership of the policy or interest in the certificate has 13890
been transferred and that the beneficiary has been designated13891
pursuant to the viatical settlement contract;13892

       (g) That entering into a viatical settlement contract may13893
cause other rights or benefits, including conversion rights and13894
waiver of premium benefits that may exist under the policy, to be 13895
forfeited by the viator and that assistance should be sought from 13896
a financial advisor.13897

       (h) That following execution of the viatical settlement 13898
contract, the viatical settlement provider or the authorized 13899
representative of the viatical settlement provider may contact 13900
the insured for the purpose of determining the insured's health 13901
status and to confirm the insured's residential or business 13902
address and telephone number or for other purposes permitted by 13903
law. Any such contact shall be limited to once in any 13904
three-month period if the insured has a life expectancy of more 13905
than one year or to once per month if the insured has a life 13906
expectancy of one year or less.13907

       (2) The viatical settlement provider or viatical settlement13908
broker shall provide the disclosures under division (A)(1) of 13909
this section in a separate document that is signed by the viator 13910
and the viatical settlement provider or viatical settlement13911
broker.13912

       (3) Disclosure to a viator under division (A)(1) of this13913
section shall include distribution of a brochure describing the13914
process of viatical settlements. The viatical settlement provider13915
or viatical settlement broker shall use the NAIC's form for the13916
brochure unless another form is developed or approved by the 13917
superintendent.13918

       (4) The disclosure document under division (A)(1) of this13919
section shall contain the following language:13920

       "All medical, financial, or personal information solicited or13921
obtained by a viatical settlement provider or viatical settlement13922
broker about an insured, including the insured's identity or the13923
identity of family members, a spouse, or a significant other may13924
be disclosed as necessary to effect the viatical settlement13925
between the viator and the viatical settlement provider. If you13926
are asked to provide this information, you will be asked to13927
consent to the disclosure. The information may be provided to13928
someone who buys the policy or provides funds for the purchase.13929
You may be asked to renew your permission to share information13930
every two years."13931

       (B)(1) A viatical settlement provider shall disclose at13932
least the following to a viator prior to the date the viatical13933
settlement contract is signed by all the necessary parties:13934

       (a) The affiliation, if any, between the viatical settlement13935
provider and the issuer of the policy to be viaticated;13936

       (b) The name, business address, and telephone number of the 13937
viatical settlement provider;13938

       (c) Regarding a viatical settlement broker, the amount and13939
method of calculating the broker's compensation. As used in this13940
division, "compensation" includes anything of value paid or given13941
to a viatical settlement broker for the placement of a policy or13942
certificate.13943

       (d) Any affiliations or contractual arrangements between the 13944
viatical settlement provider and the viatical settlement broker;13945

       (e) If a policy to be viaticated has been issued as a joint13946
policy or involves family riders or any coverage of a life other 13947
than the insured under the policy to be viaticated, the possible13948
loss of coverage on the other lives under the policy and that 13949
advice should be sought from the viator's insurance agent or the 13950
company issuing the policy;13951

       (f) The dollar amount of the current death benefit payable to 13952
the viatical settlement provider under the policy, and, if known, 13953
the availability of any additional guaranteed insurance benefits, 13954
the dollar amount of any accidental death and dismemberment 13955
benefits under the policy, and the extent to which the viator's 13956
interest in those benefits will be transferred as a result of 13957
the viatical settlement contract.13958

        (g) That an escrow agent shall provide escrow services to 13959
the parties pursuant to a written agreement, signed by the 13960
viatical settlement provider, the viatical settlement broker, and 13961
the viator. At the close of escrow, the escrow agent will 13962
distribute the proceeds of the sale to the viator, minus any 13963
compensation to be paid to any other persons who provided 13964
services and to whom the viator has agreed to compensate out of 13965
the gross amount offered by the viatical settlement purchaser. 13966
All persons receiving any form of compensation under the escrow 13967
agreement shall be clearly identified, including name, business 13968
address, telephone number, and tax identification number.13969

       (2) The viatical settlement broker shall disclose at least 13970
the following to a viator prior to the execution of the viatical 13971
settlement contract:13972

       (a) The name, business address, and telephone number of the 13973
viatical settlement broker;13974

       (b) A full, complete, and accurate description of all offers, 13975
counteroffers, acceptances, and rejections relating to the 13976
proposed viatical settlement contract;13977

       (c) Any affiliations or contractual agreements between the 13978
viatical settlement broker and any person making an offer in 13979
connection with the proposed viatical settlement contract;13980

       (d) The amount and method of calculating the viatical 13981
settlement broker's compensation and, if any portion of the 13982
viatical settlement broker's compensation is taken from the 13983
viatical settlement offer, the total amount of the viatical 13984
settlement offer and the viatical settlement broker's 13985
compensation as a percentage of that total. As used in this 13986
division, "compensation" includes anything of value paid or given 13987
to a viatical settlement broker related to the settlement of a 13988
policy.13989

       (3) The viatical settlement provider or viatical settlement13990
broker shall conspicuously display the disclosures required 13991
under divisions (B)(1) and (2) of this section in the viatical 13992
settlement contract or in a separate document signed by the 13993
viator and the viatical settlement provider or viatical 13994
settlement broker, as appropriate.13995

       (C) If the viatical settlement provider transfers ownership 13996
or changes the beneficiary of the policy, the viatical 13997
settlement provider shall communicate in writing the change in 13998
ownership or beneficiary to the insured within twenty days after 13999
the change.14000

       Sec. 3923.122.  (A) Every policy of group sickness and14001
accident insurance providing hospital, surgical, or medical14002
expense coverage for other than specific diseases or accidents14003
only, and delivered, issued for delivery, or renewed in this state 14004
on or after January 1, 1976, shall include a provision giving each 14005
insured the option to convert to the following:14006

       (1) In the case of an individual who is not a federally 14007
eligible individual, any of the individual policies of hospital, 14008
surgical, or medical expense insurance then being issued by the 14009
insurer with benefit limits not to exceed those in effect under 14010
the group policy;14011

       (2) In the case of a federally eligible individual, a basic 14012
or standard plan established by the board of directors of the Ohio 14013
health reinsurance program or plans substantially similar to the 14014
basic and standard plan in benefit design and scope of covered14015
services. For purposes of division (A)(2) of this section, the14016
superintendent of insurance shall determine whether a plan is14017
substantially similar to the basic or standard plan in benefit14018
design and scope of covered services.14019

       (B) An option for conversion to an individual policy shall be 14020
available without evidence of insurability to every insured,14021
including any person eligible under division (D) of this section,14022
who terminates employment or membership in the group holding the 14023
policy after having been continuously insured thereunder for at 14024
least one year.14025

       Upon receipt of the insured's written application and upon14026
payment of at least the first quarterly premium not later than14027
thirty-one days after the termination of coverage under the group14028
policy, the insurer shall issue a converted policy on a form then14029
available for conversion. The premium shall be in accordance with 14030
the insurer's table of premium rates in effect on the later of the 14031
following dates:14032

       (1) The effective date of the converted policy;14033

       (2) The date of application therefor; and shall be applicable 14034
to the class of risk to which each person covered belongs and to 14035
the form and amount of the policy at the person's then attained 14036
age. However, premiums charged federally eligible individuals may 14037
not exceed an amount that is two times the midpoint of the 14038
standard rate charged any other individual of a group to which the 14039
insurer is currently accepting new business and for which similar 14040
copayments and deductibles are applied.14041

       At the election of the insurer, a separate converted policy14042
may be issued to cover any dependent of an employee or member of14043
the group.14044

       Except as provided in division (H) of this section, any14045
converted policy shall become effective as of the day following14046
the date of termination of insurance under the group policy.14047

       Any probationary or waiting period set forth in the converted 14048
policy is deemed to commence on the effective date of the 14049
insured's coverage under the group policy.14050

       (C) No insurer shall be required to issue a converted policy 14051
to any person who is, or is eligible to be, covered for benefits 14052
at least comparable to the group policy under:14053

       (1) Title XVIII of the Social Security Act, as amended or14054
supersededThe medicare program;14055

       (2) Any act of congress or law under this or any other state 14056
of the United States that duplicates coverage offered under14057
division (C)(1) of this section;14058

       (3) Any policy that duplicates coverage offered under14059
division (C)(1) of this section;14060

       (4) Any other group sickness and accident insurance providing 14061
hospital, surgical, or medical expense coverage for other than 14062
specific diseases or accidents only.14063

       (D) The option for conversion shall be available:14064

       (1) Upon the death of the employee or member, to the14065
surviving spouse with respect to such of the spouse and dependents 14066
as are then covered by the group policy;14067

       (2) To a child solely with respect to the child upon14068
attaining the limiting age of coverage under the group policy14069
while covered as a dependent thereunder;14070

       (3) Upon the divorce, dissolution, or annulment of the14071
marriage of the employee or member, to the divorced spouse, or14072
former spouse in the event of annulment, of such employee or14073
member, or upon the legal separation of the spouse from such14074
employee or member, to the spouse.14075

       Persons possessing the option for conversion pursuant to this 14076
division shall be considered members for the purposes of division 14077
(H) of this section.14078

       (E) If coverage is continued under a group policy on an14079
employee following retirement prior to the time the employee is, 14080
or is eligible to be, covered by Title XVIII of the Social 14081
Security Actmedicare program, the employee may elect, in lieu of 14082
the continuance of group insurance, to have the same conversion 14083
rights as would apply had the employee's insurance terminated at 14084
retirement by reason of termination of employment.14085

       (F) If the insurer and the group policyholder agree upon one 14086
or more additional plans of benefits to be available for converted 14087
policies, the applicant for the converted policy may elect such a 14088
plan in lieu of a converted policy.14089

       (G) The converted policy may contain provisions for avoiding 14090
duplication of benefits provided pursuant to divisions (C)(1), 14091
(2), (3), and (4) of this section or provided under any other 14092
insured or noninsured plan or program.14093

       (H) If an employee or member becomes entitled to obtain a14094
converted policy pursuant to this section, and if the employee or14095
member has not received notice of the conversion privilege at14096
least fifteen days prior to the expiration of the thirty-one-day14097
conversion period provided in division (B) of this section, then14098
the employee or member has an additional period within which to14099
exercise the privilege. This additional period shall expire14100
fifteen days after the employee or member receives notice, but in14101
no event shall the period extend beyond sixty days after the14102
expiration of the thirty-one-day conversion period.14103

       Written notice presented to the employee or member, or mailed 14104
by the policyholder to the last known address of the employee or 14105
member as indicated on its records, constitutes notice for the 14106
purpose of this division. In the case of a person who is eligible 14107
for a converted policy under division (D)(2) or (D)(3) of this 14108
section, a policyholder shall not be responsible for presenting or 14109
mailing such notice, unless such policyholder has actual knowledge 14110
of the person's eligibility for a converted policy.14111

       If an additional period is allowed by an employee or member14112
for the exercise of a conversion privilege, and if written14113
application for the converted policy, accompanied by at least the14114
first quarterly premium, is made after the expiration of the14115
thirty-one-day conversion period, but within the additional period 14116
allowed an employee or member in accordance with this division, 14117
the effective date of the converted policy shall be the date of 14118
application.14119

       (I) The converted policy may provide that any hospital, 14120
surgical, or medical expense benefits otherwise payable with 14121
respect to any person may be reduced by the amount of any such 14122
benefits payable under the group policy for the same loss after 14123
termination of coverage.14124

       (J) The converted policy may contain:14125

       (1) Any exclusion, reduction, or limitation contained in the 14126
group policy or customarily used in individual policies issued by 14127
the insurer;14128

       (2) Any provision permitted in this section;14129

       (3) Any other provision not prohibited by law.14130

       Any provision required or permitted in this section may be14131
made a part of any converted policy by means of an endorsement or14132
rider.14133

       (K) The time limit specified in a converted policy for14134
certain defenses with respect to any person who was covered by a14135
group policy shall commence on the effective date of such person's 14136
coverage under the group policy.14137

       (L) No insurer shall use deterioration of health as the basis 14138
for refusing to renew a converted policy.14139

       (M) No insurer shall use age as the basis for refusing to14140
renew a converted policy.14141

       (N) A converted policy made available pursuant to this14142
section shall, if delivery of the policy is to be made in this14143
state, comply with this section. If delivery of a converted policy 14144
is to be made in another state, it may be on a form offered by the 14145
insurer in the jurisdiction where the delivery is to be made and 14146
which provides benefits substantially in compliance with those 14147
required in a policy delivered in this state.14148

       (O) As used in this section, "federally eligible individual" 14149
means an eligible individual as defined in 45 C.F.R. 148.103.14150

       Sec. 3923.27.  No policy of sickness and accident insurance14151
delivered, issued for delivery, or renewed in this state after 14152
August 26, 1976, including both individual and group policies, 14153
that provides hospitalization coverage for mental illness shall 14154
exclude such coverage for the reason that the insured is 14155
hospitalized in an institution or facility receiving tax support 14156
from the state, any municipal corporation, county, or joint county 14157
board, whether such institution or facility is deemed charitable 14158
or otherwise, provided the institution or facility or portion 14159
thereof is fully accredited by the joint commission on 14160
accreditation of hospitals or certified under Titles XVIII and XIX 14161
of the "Social Security Act of 1935," 79 Stat. 291, 42 U.S.C.A. 14162
1395, as amendedmedicare program and medicaid program. The14163
insurance coverage shall provide payment amounting to the lesser14164
of either the full amount of the statutory charge for the cost of14165
the services pursuant to section 5121.33 of the Revised Code or 14166
the benefits payable for the services under the applicable 14167
insurance policy. Insurance benefits for the coverage shall be 14168
paid so long as patients and their liable relatives retain their 14169
statutory liability pursuant to section 5121.33 of the Revised 14170
Code. Only that portion or per cent of the benefits shall be 14171
payable that has been assigned, or ordered to be paid, to the 14172
state or other appropriate provider for services rendered by the14173
institution or facility.14174

       Sec. 3923.281.  (A) As used in this section:14175

       (1) "Biologically based mental illness" means schizophrenia, 14176
schizoaffective disorder, major depressive disorder, bipolar 14177
disorder, paranoia and other psychotic disorders, 14178
obsessive-compulsive disorder, and panic disorder, as these terms 14179
are defined in the most recent edition of the diagnostic and 14180
statistical manual of mental disorders published by the American 14181
psychiatric association.14182

       (2) "Policy of sickness and accident insurance" has the same 14183
meaning as in section 3923.01 of the Revised Code, but excludes14184
any hospital indemnity, medicare supplement, long-term care, 14185
disability income, one-time-limited-duration policy of not longer 14186
than six months, supplemental benefit, or other policy that14187
provides coverage for specific diseases or accidents only; any 14188
policy that provides coverage for workers' compensation claims 14189
compensable pursuant to Chapters 4121. and 4123. of the Revised 14190
Code; any policy that provides coverage to beneficiaries enrolled 14191
in Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 14192
42 U.S.C.A. 301, as amended, known as the medical assistance 14193
program or medicaid, as provided by the Ohio department of job 14194
and family services under Chapter 5111. of the Revised Code14195
program; and any policy that provides coverage to beneficiaries 14196
enrolled in the children's buy-in program established under 14197
sections 5101.5211 to 5101.5216 of the Revised Code.14198

       (B) Notwithstanding section 3901.71 of the Revised Code, and 14199
subject to division (E) of this section, every policy of 14200
sickness and accident insurance shall provide benefits for the 14201
diagnosis and treatment of biologically based mental illnesses on 14202
the same terms and conditions as, and shall provide benefits no 14203
less extensive than, those provided under the policy of sickness 14204
and accident insurance for the treatment and diagnosis of all 14205
other physical diseases and disorders, if both of the following 14206
apply:14207

       (1) The biologically based mental illness is clinically 14208
diagnosed by a physician authorized under Chapter 4731. of the 14209
Revised Code to practice medicine and surgery or osteopathic 14210
medicine and surgery; a psychologist licensed under Chapter 4732. 14211
of the Revised Code; a professional clinical counselor, 14212
professional counselor, or independent social worker licensed 14213
under Chapter 4757. of the Revised Code; or a clinical nurse14214
specialist licensed under Chapter 4723. of the Revised Code whose 14215
nursing specialty is mental health.14216

       (2) The prescribed treatment is not experimental or14217
investigational, having proven its clinical effectiveness in14218
accordance with generally accepted medical standards.14219

       (C) Division (B) of this section applies to all coverages and14220
terms and conditions of the policy of sickness and accident14221
insurance, including, but not limited to, coverage of inpatient14222
hospital services, outpatient services, and medication; maximum14223
lifetime benefits; copayments; and individual and family14224
deductibles.14225

       (D) Nothing in this section shall be construed as prohibiting14226
a sickness and accident insurance company from taking any of the14227
following actions:14228

       (1) Negotiating separately with mental health care providers14229
with regard to reimbursement rates and the delivery of health care14230
services;14231

       (2) Offering policies that provide benefits solely for the14232
diagnosis and treatment of biologically based mental illnesses;14233

       (3) Managing the provision of benefits for the diagnosis or14234
treatment of biologically based mental illnesses through the use 14235
of pre-admission screening, by requiring beneficiaries to obtain 14236
authorization prior to treatment, or through the use of any other 14237
mechanism designed to limit coverage to that treatment determined 14238
to be necessary;14239

       (4) Enforcing the terms and conditions of a policy of14240
sickness and accident insurance.14241

       (E) An insurer that offers any policy of sickness and 14242
accident insurance is not required to provide benefits for the 14243
diagnosis and treatment of biologically based mental illnesses 14244
pursuant to division (B) of this section if all of the following 14245
apply:14246

       (1) The insurer submits documentation certified by an 14247
independent member of the American academy of actuaries to the 14248
superintendent of insurance showing that incurred claims for 14249
diagnostic and treatment services for biologically based mental 14250
illnesses for a period of at least six months independently caused 14251
the insurer's costs for claims and administrative expenses for the 14252
coverage of all other physical diseases and disorders to increase 14253
by more than one per cent per year. 14254

       (2) The insurer submits a signed letter from an independent 14255
member of the American academy of actuaries to the superintendent 14256
of insurance opining that the increase described in division 14257
(E)(1) of this section could reasonably justify an increase of 14258
more than one per cent in the annual premiums or rates charged by 14259
the insurer for the coverage of all other physical diseases and 14260
disorders.14261

       (3) The superintendent of insurance makes the following 14262
determinations from the documentation and opinion submitted 14263
pursuant to divisions (E)(1) and (2) of this section:14264

       (a) Incurred claims for diagnostic and treatment services for 14265
biologically based mental illnesses for a period of at least six 14266
months independently caused the insurer's costs for claims and 14267
administrative expenses for the coverage of all other physical 14268
diseases and disorders to increase by more than one per cent per 14269
year.14270

       (b) The increase in costs reasonably justifies an increase of 14271
more than one per cent in the annual premiums or rates charged by 14272
the insurer for the coverage of all other physical diseases and 14273
disorders.14274

       Any determination made by the superintendent under this 14275
division is subject to Chapter 119. of the Revised Code.14276

       Sec. 3923.33.  As used in section 3923.33 and sections14277
3923.331 to 3923.339 of the Revised Code:14278

       (A) "Applicant" means:14279

       (1) In the case of an individual medicare supplement policy, 14280
the person who seeks to contract for insurance benefits; and14281

       (2) In the case of a group medicare supplement policy, the14282
proposed certificate holder.14283

       (B) "Certificate" means, for purposes of section 3923.33 and 14284
sections 3923.331 to 3923.339 of the Revised Code, any certificate 14285
delivered or issued for delivery in this state under a group 14286
medicare supplement policy.14287

       (C) "Certificate form" means the form on which the14288
certificate is delivered or issued for delivery by the issuer.14289

       (D) "Direct response insurance policy" means a medicare14290
supplement policy or certificate marketed without the direct14291
involvement of an insurance agent.14292

       (E) "Issuer" includes insurance companies, fraternal benefit 14293
societies, health insuring corporations, and any other entities 14294
delivering or issuing for delivery in this state medicare 14295
supplement policies or certificates.14296

       (F) "Medicare" means the "Health Insurance for the Aged Act," 14297
Title XVIII of the Social Security Amendments of 1965, 79 Stat. 14298
291, 42 U.S.C.A. 1395, as then constituted or later amended.14299

       (G) "Medicare supplement policy" means a group or individual 14300
policy of sickness and accident insurance or a subscriber contract 14301
of health insuring corporations or any other issuers, other than a 14302
policy issued pursuant to a contract under section 1876 of the 14303
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A., 1395mm, 14304
as amended, or an issued policy under any demonstration project 14305
specified in 42 U.S.C.A. 1395ss(g)(1), which is advertised,14306
marketed, or designed primarily as a supplement to reimbursements14307
under medicare for the hospital, medical, or surgical expenses of14308
persons eligible for medicare.14309

       (H)(G) "Policy form" means the form on which the policy is14310
delivered or issued for delivery by the issuer.14311

       Sec. 3923.38.  (A) As used in this section:14312

       (1) "Group policy" includes any group sickness and accident 14313
policy or contract delivered, issued for delivery, or renewed in 14314
this state on or after June 28, 1984, and any private or public 14315
employer self-insurance plan or other plan that provides, or 14316
provides payment for, health care benefits for employees resident 14317
in this state other than through an insurer or health insuring 14318
corporation, to which both of the following apply:14319

       (a) The policy insures employees for hospital, surgical, or 14320
major medical insurance on an expense incurred or service basis, 14321
other than for specified diseases or for accidental injuries only.14322

       (b) The policy is in effect and covers an eligible employee 14323
at the time the employee's employment is terminated.14324

       (2) "Eligible employee" includes only an employee to whom all 14325
of the following apply:14326

       (a) The employee has been continuously insured under a group 14327
policy or under the policy and any prior similar group coverage 14328
replaced by the policy, during the entire three-month period 14329
preceding the termination of the employee's employment.14330

       (b) The employee is entitled, at the time of the termination 14331
of the employee's employment, to unemployment compensation14332
benefits under Chapter 4141. of the Revised Code.14333

       (c) The employee is not, and does not become, covered by or 14334
eligible for coverage by medicare under Title XVIII of the Social 14335
Security Act, as amended.14336

       (d) The employee is not, and does not become, covered by or 14337
eligible for coverage by any other insured or uninsured14338
arrangement that provides hospital, surgical, or medical coverage14339
for individuals in a group and under which the person was not14340
covered immediately prior to such termination. A person eligible14341
for continuation of coverage under this section, who is also14342
eligible for coverage under section 3923.123 of the Revised Code,14343
may elect either coverage, but not both. A person who elects14344
continuation of coverage may elect any coverage available under14345
section 3923.123 of the Revised Code upon the termination of the14346
continuation of coverage.14347

       (3) "Group rate" means, in the case of an employer14348
self-insurance or other health benefits plan, the average monthly14349
cost per employee, over a period of at least twelve months, of the 14350
operation of the plan that would represent a group insurance rate 14351
if the same coverage had been provided under a group sickness and 14352
accident insurance policy.14353

       (B) A group policy shall provide that any eligible employee 14354
may continue the employee's hospital, surgical, and medical 14355
insurance under the policy, for the employee and the employee's 14356
eligible dependents, for a period of six months after the date 14357
that the insurance coverage would otherwise terminate by reason of 14358
the termination of the employee's employment. Each certificate of14359
coverage, or other notice of coverage, issued to employees under14360
the policy shall include a notice of the employee's privilege of14361
continuation.14362

       (C) All of the following apply to the continuation of14363
coverage required under division (B) of this section:14364

       (1) Continuation need not include dental, vision care,14365
prescription drug benefits, or any other benefits provided under14366
the policy in addition to its hospital, surgical, or major medical 14367
benefits.14368

       (2) The employer shall notify the employee of the right of14369
continuation at the time the employer notifies the employee of the 14370
termination of employment. The notice shall inform the employee of 14371
the amount of contribution required by the employer under division 14372
(C)(4) of this section.14373

       (3) The employee shall file a written election of14374
continuation with the employer and pay the employer the first14375
contribution required under division (C)(4) of this section. The14376
request and payment must be received by the employer no later than 14377
the earlier of any of the following dates:14378

       (a) Thirty-one days after the date on which the employee's14379
coverage would otherwise terminate;14380

       (b) Ten days after the date on which the employee's coverage 14381
would otherwise terminate, if the employer has notified the 14382
employee of the right of continuation prior to such date;14383

       (c) Ten days after the employer notifies the employee of the 14384
right of continuation, if the notice is given after the date on 14385
which the employee's coverage would otherwise terminate.14386

       (4) The employee must pay to the employer, on a monthly14387
basis, in advance, the amount of contribution required by the14388
employer. The amount required shall not exceed the group rate for 14389
the insurance being continued under the policy on the due date of 14390
each payment.14391

       (5) The employee's privilege to continue coverage and the14392
coverage under any continuation ceases if any of the following14393
occurs:14394

       (a) The employee ceases to be an eligible employee under14395
division (A)(2)(c) or (d) of this section;14396

       (b) A period of six months expires after the date that the14397
employee's insurance under the policy would otherwise have14398
terminated because of the termination of employment;14399

       (c) The employee fails to make a timely payment of a required 14400
contribution, in which event the coverage shall cease at the end 14401
of the coverage for which contributions were made;14402

       (d) The policy is terminated, or the employer terminates14403
participation under the policy, unless the employer replaces the14404
coverage by similar coverage under another group policy or other14405
group health arrangement.14406

       If the employer replaces the policy with similar group health 14407
coverage, all of the following apply:14408

       (i) The member shall be covered under the replacement14409
coverage, for the balance of the period that the member would have14410
remained covered under the terminated coverage if it had not been14411
terminated.14412

       (ii) The minimum level of benefits under the replacement14413
coverage shall be the applicable level of benefits of the policy14414
replaced reduced by any benefits payable under the policy14415
replaced.14416

       (iii) The policy replaced shall continue to provide benefits 14417
to the extent of its accrued liabilities and extensions of 14418
benefits as if the replacement had not occurred.14419

       (D) This section does not apply to an employer's14420
self-insurance plan if federal law supersedes, preempts,14421
prohibits, or otherwise precludes its application to such plans.14422

       Sec. 3923.49.  The department of insurance shall establish an 14423
outreach program to educate consumers about the following:14424

       (A) The need for long-term care insurance;14425

       (B) Mechanisms for financing long-term care;14426

       (C) The availability of long-term care insurance;14427

       (D) The resource protection provided by the Ohio long-term 14428
care insurance program under section 5111.185162.43 of the 14429
Revised Code;14430

       (E) That a consumer who purchased a long-term care insurance 14431
policy that does not meet the requirements of section 3923.50 of 14432
the Revised Code may purchase a policy that meets those 14433
requirements.14434

       The department shall develop and make available to consumers 14435
information to assist them in choosing long-term care insurance 14436
coverage.14437

       Sec. 3923.50.  For the purposes of the Ohio long-term care14438
insurance program established under section 5111.185162.43 of the14439
Revised Code, the department of insurance shall notify the14440
department of job and family serviceshealth care administration14441
of all long-term care insurance policies that meet all of the 14442
following requirements:14443

       (A) Comply with sections 3923.41 to 3923.48 of the Revised14444
Code and the rules adopted under section 3923.47 of the Revised14445
Code;14446

       (B) Provide benefits for home and community-based services in 14447
addition to nursing home care;14448

       (C) Include case management services in its coverage of home14449
and community-based services;14450

       (D) Provide five per cent inflation protection compounded14451
annually;14452

       (E) Provide for the keeping of records and14453
explanation-of-benefit reports on insurance payments that count14454
toward resource exclusion for the medical assistancemedicaid14455
program;14456

       (F) Provide the information the director of job and family14457
serviceshealth care administration determines is necessary to 14458
document the extent of resource exclusion and to evaluate the Ohio 14459
long-term care insurance program;14460

       (G) Comply with other requirements established in rules14461
adopted under this section.14462

       The superintendent of insurance shall adopt rules in14463
accordance with Chapter 119. of the Revised Code establishing14464
requirements under division (G) of this section that policies must14465
meet to qualify under the Ohio long-term care insurance program.14466
The superintendent shall consult with the departments of aging and14467
job and family serviceshealth care administration in adopting 14468
those rules.14469

       Sec. 3923.58.  (A) As used in sections 3923.58 and 3923.59 of 14470
the Revised Code:14471

       (1) "Health benefit plan" and "MEWA" have the same meanings 14472
as in section 3924.01 of the Revised Code.14473

       (2) "Insurer" means any sickness and accident insurance14474
company authorized to do business in this state, or MEWA 14475
authorized to issue insured health benefit plans in this state. 14476
"Insurer" does not include any health insuring corporation that is 14477
owned or operated by an insurer.14478

       (3) "Pre-existing conditions provision" means a policy14479
provision that excludes or limits coverage for charges or expenses 14480
incurred during a specified period following the insured's 14481
effective date of coverage as to a condition which, during a 14482
specified period immediately preceding the effective date of 14483
coverage, had manifested itself in such a manner as would cause an 14484
ordinarily prudent person to seek medical advice, diagnosis, care, 14485
or treatment or for which medical advice, diagnosis, care, or 14486
treatment was recommended or received, or a pregnancy existing on 14487
the effective date of coverage.14488

       (B) Beginning in January of each year, insurers in the 14489
business of issuing individual policies of sickness and accident 14490
insurance as contemplated by section 3923.021 of the Revised Code, 14491
except individual policies issued pursuant to section 3923.122 of 14492
the Revised Code, shall accept applicants for open enrollment 14493
coverage, as set forth in this division, in the order in which14494
they apply for coverage and subject to the limitation set forth in 14495
division (G) of this section. Insurers shall accept for coverage 14496
pursuant to this section individuals to whom both of the following 14497
conditions apply:14498

       (1) The individual is not applying for coverage as an14499
employee of an employer, as a member of an association, or as a14500
member of any other group.14501

       (2) The individual is not covered, and is not eligible for14502
coverage, under any other private or public health benefits14503
arrangement, including the medicare program established under14504
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 4214505
U.S.C.A. 301, as amended, or any other act of congress or law of14506
this or any other state of the United States that provides14507
benefits comparable to the benefits provided under this section,14508
any medicare supplement policy, or any continuation of coverage 14509
policy under state or federal law.14510

       (C) An insurer shall offer to any individual accepted under 14511
this section the Ohio health care basic and standard plans 14512
established by the board of directors of the Ohio health 14513
reinsurance program under division (A) of section 3924.10 of the 14514
Revised Code or health benefit plans that are substantially 14515
similar to the Ohio health care basic and standard plans in14516
benefit plan design and scope of covered services.14517

       An insurer may offer other health benefit plans in addition 14518
to, but not in lieu of, the plans required to be offered under 14519
this division. A basic health benefit plan shall provide, at a 14520
minimum, the coverage provided by the Ohio health care basic plan 14521
or any health benefit plan that is substantially similar to the14522
Ohio health care basic plan in benefit plan design and scope of 14523
covered services. A standard health benefit plan shall provide, at 14524
a minimum, the coverage provided by the Ohio health care standard 14525
plan or any health benefit plan that is substantially similar to 14526
the Ohio health care standard plan in benefit plan design and 14527
scope of covered services.14528

       For purposes of this division, the superintendent of 14529
insurance shall determine whether a health benefit plan is 14530
substantially similar to the Ohio health care basic and standard14531
plans in benefit plan design and scope of covered services.14532

       (D) Health benefit plans issued under this section may14533
establish pre-existing conditions provisions that exclude or limit 14534
coverage for a period of up to twelve months following the14535
individual's effective date of coverage and that may relate only14536
to conditions during the six months immediately preceding the14537
effective date of coverage. 14538

       (E) Premiums charged to individuals under this section may 14539
not exceed an amount that is two and one-half times the highest 14540
rate charged any other individual to which the insurer is14541
currently accepting new business, and for which similar copayments 14542
and deductibles are applied.14543

       (F) In offering health benefit plans under this section, an 14544
insurer may require the purchase of health benefit plans that14545
condition the reimbursement of health services upon the use of a14546
specific network of providers.14547

       (G)(1) In no event shall an insurer be required to accept14548
annually under this section individuals who, in the aggregate, 14549
would cause the insurer to have a total number of new insureds 14550
that is more than one-half per cent of its total number of insured 14551
individuals in this state per year, as contemplated by section 14552
3923.021 of the Revised Code, calculated as of the immediately 14553
preceding thirty-first day of December and excluding the insurer's 14554
medicare supplement policies and conversion or continuation of 14555
coverage policies under state or federal law and any policies 14556
described in division (L) of this section. 14557

       (2) An officer of the insurer shall certify to the department 14558
of insurance when it has met the enrollment limit set forth in 14559
division (G)(1) of this section. Upon providing such14560
certification, the insurer shall be relieved of its open14561
enrollment requirement under this section for the remainder of the 14562
calendar year.14563

       (H) An insurer shall not be required to accept under this14564
section applicants who, at the time of enrollment, are confined to 14565
a health care facility because of chronic illness, permanent14566
injury, or other infirmity that would cause economic impairment to 14567
the insurer if the applicants were accepted, or to make the14568
effective date of benefits for individuals accepted under this 14569
section earlier than ninety days after the date of acceptance.14570

       (I) The requirements of this section do not apply to any14571
insurer that is currently in a state of supervision, insolvency,14572
or liquidation. If an insurer demonstrates to the satisfaction of 14573
the superintendent that the requirements of this section would 14574
place the insurer in a state of supervision, insolvency, or 14575
liquidation, the superintendent may waive or modify the 14576
requirements of division (B) or (G) of this section. The actions14577
of the superintendent under this division shall be effective for a 14578
period of not more than one year. At the expiration of such time, 14579
a new showing of need for a waiver or modification by the insurer 14580
shall be made before a new waiver or modification is issued or 14581
imposed.14582

       (J) No hospital, health care facility, or health care 14583
practitioner, and no person who employs any health care 14584
practitioner, shall balance bill any individual or dependent of an 14585
individual for any health care supplies or services provided to 14586
the individual or dependent who is insured under a policy issued 14587
under this section. The hospital, health care facility, or health 14588
care practitioner, or any person that employs the health care 14589
practitioner, shall accept payments made to it by the insurer 14590
under the terms of the policy or contract insuring or covering 14591
such individual as payment in full for such health care supplies 14592
or services.14593

       As used in this division, "hospital" has the same meaning as 14594
in section 3727.01 of the Revised Code; "health care practitioner" 14595
has the same meaning as in section 4769.01 of the Revised Code; 14596
and "balance bill" means charging or collecting an amount in 14597
excess of the amount reimbursable or payable under the policy or 14598
health care service contract issued to an individual under this14599
section for such health care supply or service. "Balance bill" 14600
does not include charging for or collecting copayments or 14601
deductibles required by the policy or contract.14602

       (K) An insurer shall pay an agent a commission in the amount 14603
of five per cent of the premium charged for initial placement or 14604
for otherwise securing the issuance of a policy or contract issued 14605
to an individual under this section, and four per cent of the 14606
premium charged for the renewal of such a policy or contract. The 14607
superintendent may adopt, in accordance with Chapter 119. of the 14608
Revised Code, such rules as are necessary to enforce this 14609
division.14610

       (L) This section does not apply to any policy that provides 14611
coverage for specific diseases or accidents only, or to any 14612
hospital indemnity, medicare supplement, long-term care,14613
disability income, one-time-limited-duration policy of no longer 14614
than six months, or other policy that offers only supplemental 14615
benefits.14616

       Sec. 3923.601. (A)(1) This section applies to both of the 14617
following:14618

       (a) A sickness and accident insurer that issues or requires 14619
the use of a standardized identification card or an electronic 14620
technology for submission and routing of prescription drug claims 14621
pursuant to a policy, contract, or agreement for health care 14622
services;14623

        (b) A person that a sickness and accident insurer contracts 14624
with to issue a standardized identification card or an electronic 14625
technology described in division (A)(1)(a) of this section.14626

       (2) Notwithstanding division (A)(1) of this section, this 14627
section does not apply to the issuance or required use of a14628
standardized identification card or an electronic technology for 14629
the submission and routing of prescription drug claims in 14630
connection with any of the following:14631

       (a) Any individual or group policy of sickness and accident 14632
insurance covering only accident, credit, dental, disability 14633
income, long-term care, hospital indemnity, medicare supplement, 14634
medicare, tricare, specified disease, or vision care; coverage 14635
under a one-time-limited-duration policy of not longer than six 14636
months; coverage issued as a supplement to liability insurance; 14637
insurance arising out of workers' compensation or similar law; 14638
automobile medical payment insurance; or insurance under which 14639
benefits are payable with or without regard to fault and which is 14640
statutorily required to be contained in any liability insurance 14641
policy or equivalent self-insurance.14642

       (b) Coverage provided under the medicaid, as defined in 14643
section 5111.01 of the Revised Codeprogram.14644

       (c) Coverage provided under an employer's self-insurance plan 14645
or by any of its administrators, as defined in section 3959.01 of 14646
the Revised Code, to the extent that federal law supersedes, 14647
preempts, prohibits, or otherwise precludes the application of 14648
this section to the plan and its administrators.14649

       (B) A standardized identification card or an electronic14650
technology issued or required to be used as provided in division 14651
(A)(1) of this section shall contain uniform prescription drug 14652
information in accordance with either division (B)(1) or (2) of 14653
this section.14654

        (1) The standardized identification card or the electronic 14655
technology shall be in a format and contain information fields 14656
approved by the national council for prescription drug programs or 14657
a successor organization, as specified in the council's or 14658
successor organization's pharmacy identification card 14659
implementation guide in effect on the first day of October most 14660
immediately preceding the issuance or required use of the 14661
standardized identification card or the electronic technology.14662

        (2) If the insurer or person under contract with the insurer 14663
to issue a standardized identification card or an electronic 14664
technology requires the information for the submission and routing 14665
of a claim, the standardized identification card or the electronic 14666
technology shall contain any of the following information:14667

        (a) The insurer's name;14668

        (b) The insured's name, group number, and identification14669
number;14670

       (c) A telephone number to inquire about pharmacy-related 14671
issues;14672

        (d) The issuer's international identification number, labeled 14673
as "ANSI BIN" or "RxBIN";14674

        (e) The processor's control number, labeled as "RxPCN";14675

        (f) The insured's pharmacy benefits group number if different 14676
from the insured's medical group number, labeled as "RxGrp."14677

        (C) If the standardized identification card or the electronic 14678
technology issued or required to be used as provided in division 14679
(A)(1) of this section is also used for submission and routing of 14680
nonpharmacy claims, the designation "Rx" is required to be 14681
included as part of the labels identified in divisions (B)(2)(d) 14682
and (e) of this section if the issuer's international 14683
identification number or the processor's control number is 14684
different for medical and pharmacy claims.14685

        (D) Each sickness and accident insurer described in division 14686
(A) of this section shall annually file a certificate with the 14687
superintendent of insurance certifying that it or any person it 14688
contracts with to issue a standardized identification card or 14689
electronic technology for submission and routing of prescription 14690
drug claims complies with this section.14691

       (E)(1) Except as provided in division (E)(2) of this section, 14692
if there is a change in the information contained in the 14693
standardized identification card or the electronic technology 14694
issued to an insured, the insurer or person under contract with 14695
the insurer to issue a standardized identification card or an 14696
electronic technology shall issue a new card or electronic 14697
technology to the insured.14698

        (2) An insurer or person under contract with the insurer is 14699
not required under division (E)(1) of this section to issue a new 14700
card or electronic technology to an insured more than once during 14701
a twelve-month period.14702

        (F) Nothing in this section shall be construed as requiring 14703
an insurer to produce more than one standardized identification 14704
card or one electronic technology for use by insureds accessing 14705
health care benefits provided under a policy of sickness and 14706
accident insurance.14707

       Sec. 3923.70.  Consistent with the Rules of Evidence, a 14708
written decision or opinion prepared by an independent review 14709
organization under section 3923.67 or 3923.68 of the Revised Code 14710
shall be admissible in any civil action related to the coverage 14711
decision that was the subject of the decision or opinion. The 14712
independent review organization's decision or opinion shall be 14713
presumed to be a scientifically valid and accurate description of 14714
the state of medical knowledge at the time it was written.14715

       Consistent with the Rules of Evidence, any party to a civil 14716
action related to an insurer's decision involving an 14717
investigational or experimental drug, device, or treatment may 14718
introduce into evidence any applicable medicare reimbursement 14719
standards established under Title XVIII of the "Social Security 14720
Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amendedmedicare 14721
program.14722

       Sec. 3923.79.  Consistent with the Rules of Evidence, a 14723
written decision or opinion prepared by an independent review 14724
organization under section 3923.76 or 3923.77 of the Revised Code 14725
shall be admissible in any civil action related to the coverage 14726
decision that was the subject of the decision or opinion. The 14727
independent review organization's decision or opinion shall be 14728
presumed to be a scientifically valid and accurate description of 14729
the state of medical knowledge at the time it was written.14730

       Consistent with the Rules of Evidence, any party to a civil 14731
action related to a plan's decision involving an investigational 14732
or experimental drug, device, or treatment may introduce into14733
evidence any applicable medicare reimbursement standards14734
established under Title XVIII of the "Social Security Act," 4914735
Stat. 620 (1935), 42 U.S.C.A. 301, as amendedmedicare program.14736

       Sec. 3923.83. (A)(1) This section applies to both of the 14737
following:14738

       (a) A public employee benefit plan that issues or requires 14739
the use of a standardized identification card or an electronic 14740
technology for submission and routing of prescription drug claims 14741
pursuant to a policy, contract, or agreement for health care 14742
services;14743

        (b) A person or entity that a public employee benefit plan 14744
contracts with to issue a standardized identification card or an 14745
electronic technology described in division (A)(1)(a) of this 14746
section.14747

       (2) Notwithstanding division (A)(1) of this section, this 14748
section does not apply to the issuance or required use of a14749
standardized identification card or an electronic technology for 14750
the submission and routing of prescription drug claims in 14751
connection with either of the following:14752

       (a) Any individual or group policy of insurance covering only 14753
accident, credit, dental, disability income, long-term care, 14754
hospital indemnity, medicare supplement, medicare, tricare, 14755
specified disease, or vision care; coverage under a 14756
one-time-limited-duration policy of not longer than six months; 14757
coverage issued as a supplement to liability insurance; insurance 14758
arising out of workers' compensation or similar law; automobile 14759
medical payment insurance; or insurance under which benefits are 14760
payable with or without regard to fault and which is statutorily 14761
required to be contained in any liability insurance policy or 14762
equivalent self-insurance.14763

       (b) Coverage provided under the medicaid, as defined in 14764
section 5111.01 of the Revised Codeprogram.14765

       (B) A standardized identification card or an electronic14766
technology issued or required to be used as provided in division 14767
(A)(1) of this section shall contain uniform prescription drug 14768
information in accordance with either division (B)(1) or (2) of 14769
this section.14770

        (1) The standardized identification card or the electronic 14771
technology shall be in a format and contain information fields 14772
approved by the national council for prescription drug programs or 14773
a successor organization, as specified in the council's or 14774
successor organization's pharmacy identification card 14775
implementation guide in effect on the first day of October most 14776
immediately preceding the issuance or required use of the 14777
standardized identification card or the electronic technology.14778

        (2) If the public employee benefit plan or person under 14779
contract with the plan to issue a standardized identification card 14780
or an electronic technology requires the information for the 14781
submission and routing of a claim, the standardized identification 14782
card or the electronic technology shall contain any of the14783
following information:14784

        (a) The plan's name;14785

        (b) The insured's name, group number, and identification14786
number;14787

       (c) A telephone number to inquire about pharmacy-related 14788
issues;14789

        (d) The issuer's international identification number, labeled 14790
as "ANSI BIN" or "RxBIN";14791

        (e) The processor's control number, labeled as "RxPCN";14792

        (f) The insured's pharmacy benefits group number if different 14793
from the insured's medical group number, labeled as "RxGrp."14794

        (C) If the standardized identification card or the electronic 14795
technology issued or required to be used as provided in division 14796
(A)(1) of this section is also used for submission and routing of 14797
nonpharmacy claims, the designation "Rx" is required to be 14798
included as part of the labels identified in divisions (B)(2)(d) 14799
and (e) of this section if the issuer's international 14800
identification number or the processor's control number is 14801
different for medical and pharmacy claims.14802

        (D)(1) Except as provided in division (D)(2) of this section, 14803
if there is a change in the information contained in the 14804
standardized identification card or the electronic technology 14805
issued to an insured, the public employee benefit plan or person 14806
under contract with the plan to issue a standardized 14807
identification card or electronic technology shall issue a new 14808
card or electronic technology to the insured. 14809

        (2) A public employee benefit plan or person under contract 14810
with the plan is not required under division (D)(1) of this 14811
section to issue a new card or electronic technology to an insured 14812
more than once during a twelve-month period.14813

       (F)(E) Nothing in this section shall be construed as 14814
requiring a public employee benefit plan to produce more than one 14815
standardized identification card or one electronic technology for 14816
use by insureds accessing health care benefits provided under a 14817
health benefit plan.14818

       Sec. 3924.41.  (A) As used in sections 3924.41 and 3924.42 of 14819
the Revised Code, "health insurer" means any sickness and accident 14820
insurer or health insuring corporation. "Health insurer" also 14821
includes any group health plan as defined in section 607 of the 14822
federal "Employee Retirement Income Security Act of 1974," 88 14823
Stat. 832, 29 U.S.C.A. 1167.14824

       (B) Notwithstanding any other provision of the Revised Code, 14825
no health insurer shall take into consideration the availability 14826
of, or eligibility for, medical assistancethe medicaid program in 14827
this state under Chapter 5111. of the Revised Code or in any other14828
state pursuant to Title XIX of the "Social Security Act," 49 Stat. 14829
620 (1935), 42 U.S.C.A. 301, as amended, when determining an 14830
individual's eligibility for coverage or when making payments to 14831
or on behalf of an enrollee, subscriber, policyholder, or14832
certificate holder.14833

       Sec. 3924.42.  No health insurer shall impose requirements on14834
the department of job and family serviceshealth care 14835
administration, when it has been assigned the rights of an14836
individual who is eligible for medical assistance under Chapter 14837
5111. of the Revised Codethe medicaid program and who is covered 14838
under a health care policy, contract, or plan issued by the health 14839
insurer, that are different from the requirements applicable to an14840
agent or assignee of any other individual so covered.14841

       Sec. 3963.01. As used in this chapter:14842

       (A) "Affiliate" means any person or entity that has ownership 14843
or control of a contracting entity, is owned or controlled by a 14844
contracting entity, or is under common ownership or control with a 14845
contracting entity.14846

       (B) "Basic health care services" has the same meaning as in 14847
division (A) of section 1751.01 of the Revised Code, except that 14848
it does not include any services listed in that division that are 14849
provided by a pharmacist or nursing home.14850

       (C) "Contracting entity" means any person that has a primary 14851
business purpose of contracting with participating providers for 14852
the delivery of health care services.14853

       (D) "Credentialing" means the process of assessing and 14854
validating the qualifications of a provider applying to be 14855
approved by a contracting entity to provide basic health care 14856
services, specialty health care services, or supplemental health 14857
care services to enrollees.14858

       (E) "Edit" means adjusting one or more procedure codes billed 14859
by a participating provider on a claim for payment or a practice 14860
that results in any of the following:14861

       (1) Payment for some, but not all of the procedure codes 14862
originally billed by a participating provider;14863

       (2) Payment for a different procedure code than the procedure 14864
code originally billed by a participating provider;14865

       (3) A reduced payment as a result of services provided to an 14866
enrollee that are claimed under more than one procedure code on 14867
the same service date.14868

       (F) "Electronic claims transport" means to accept and 14869
digitize claims or to accept claims already digitized, to place 14870
those claims into a format that complies with the electronic 14871
transaction standards issued by the United States department of 14872
health and human services pursuant to the "Health Insurance 14873
Portability and Accountability Act of 1996," 110 Stat. 1955, 42 14874
U.S.C. 1320d, et seq., as those electronic standards are 14875
applicable to the parties and as those electronic standards are 14876
updated from time to time, and to electronically transmit those 14877
claims to the appropriate contracting entity, payer, or 14878
third-party administrator.14879

       (G) "Enrollee" means any person eligible for health care 14880
benefits under a health benefit plan, including an eligible 14881
recipient of medicaid under Chapter 5111. of the Revised Code, and 14882
includes all of the following terms:14883

       (1) "Enrollee" and "subscriber" as defined by section 1751.01 14884
of the Revised Code;14885

       (2) "Member" as defined by section 1739.01 of the Revised 14886
Code;14887

       (3) "Insured" and "plan member" pursuant to Chapter 3923. of 14888
the Revised Code;14889

       (4) "Beneficiary" as defined by section 3901.38 of the 14890
Revised Code.14891

       (H) "Health care contract" means a contract entered into, 14892
materially amended, or renewed between a contracting entity and 14893
a participating provider for the delivery of basic health care 14894
services, specialty health care services, or supplemental health 14895
care services to enrollees.14896

       (I) "Health care services" means basic health care services, 14897
specialty health care services, and supplemental health care 14898
services.14899

       (J) "Material amendment" means an amendment to a health care 14900
contract that decreases the participating provider's payment or 14901
compensation, changes the administrative procedures in a way that 14902
may reasonably be expected to significantly increase the 14903
provider's administrative expenses, or adds a new product. A 14904
material amendment does not include any of the following:14905

       (1) A decrease in payment or compensation resulting solely 14906
from a change in a published fee schedule upon which the payment 14907
or compensation is based and the date of applicability is clearly 14908
identified in the contract;14909

       (2) A decrease in payment or compensation that was 14910
anticipated under the terms of the contract, if the amount and 14911
date of applicability of the decrease is clearly identified in the 14912
contract;14913

       (3) An administrative change that may significantly increase 14914
the provider's administrative expense, the specific applicability 14915
of which is clearly identified in the contract;14916

       (4) Changes to an existing prior authorization, 14917
precertification, notification, or referral program that do not 14918
substantially increase the provider's administrative expense;14919

       (5) Changes to an edit program or to specific edits if the 14920
participating provider is provided notice of the changes pursuant 14921
to division (A)(1) of section 3963.04 of the Revised Code and the 14922
notice includes information sufficient for the provider to 14923
determine the effect of the change;14924

       (6) Changes to a health care contract described in division 14925
(B) of section 3963.04 of the Revised Code.14926

       (K) "Participating provider" means a provider that has a 14927
health care contract with a contracting entity and is entitled to 14928
reimbursement for health care services rendered to an enrollee 14929
under the health care contract.14930

       (L) "Payer" means any person that assumes the financial risk 14931
for the payment of claims under a health care contract or the 14932
reimbursement for health care services provided to enrollees by 14933
participating providers pursuant to a health care contract.14934

       (M) "Primary enrollee" means a person who is responsible for 14935
making payments for participation in a health care plan or an 14936
enrollee whose employment or other status is the basis of 14937
eligibility for enrollment in a health care plan.14938

       (N) "Procedure codes" includes the American medical 14939
association's current procedural terminology code, the American 14940
dental association's current dental terminology, and the centers 14941
for medicare and medicaid services health care common procedure 14942
coding system.14943

       (O) "Product" means one of the following types of categories 14944
of coverage for which a participating provider may be obligated 14945
to provide health care services pursuant to a health care 14946
contract:14947

       (1) A health maintenance organization or other product 14948
provided by a health insuring corporation;14949

       (2) A preferred provider organization;14950

       (3) Medicare;14951

       (4) Medicaid or the children's buy-in program established 14952
under section 5101.5211 to 5101.5216 of the Revised Code;14953

       (5) Workers' compensation.14954

       (P) "Provider" means a physician, podiatrist, dentist, 14955
chiropractor, optometrist, psychologist, physician assistant, 14956
advanced practice nurse, occupational therapist, massage 14957
therapist, physical therapist, professional counselor, 14958
professional clinical counselor, hearing aid dealer, orthotist, 14959
prosthetist, home health agency, hospice care program, or 14960
hospital, or a provider organization or physician-hospital 14961
organization that is acting exclusively as an administrator on 14962
behalf of a provider to facilitate the provider's participation in 14963
health care contracts. "Provider" does not mean a pharmacist, 14964
pharmacy, nursing home, or a provider organization or 14965
physician-hospital organization that leases the provider 14966
organization's or physician-hospital organization's network to a 14967
third party or contracts directly with employers or health and 14968
welfare funds.14969

       (Q) "Specialty health care services" has the same meaning as 14970
in section 1751.01 of the Revised Code, except that it does not 14971
include any services listed in division (B) of section 1751.01 of 14972
the Revised Code that are provided by a pharmacist or a nursing 14973
home.14974

       (R) "Supplemental health care services" has the same meaning 14975
as in division (B) of section 1751.01 of the Revised Code, except 14976
that it does not include any services listed in that division that 14977
are provided by a pharmacist or nursing home.14978

       Sec. 4123.27.  Information contained in the annual statement14979
provided for in section 4123.26 of the Revised Code, and such14980
other information as may be furnished to the bureau of workers'14981
compensation by employers in pursuance of that section, is for the14982
exclusive use and information of the bureau in the discharge of14983
its official duties, and shall not be open to the public nor be14984
used in any court in any action or proceeding pending therein14985
unless the bureau is a party to the action or proceeding; but the14986
information contained in the statement may be tabulated and14987
published by the bureau in statistical form for the use and14988
information of other state departments and the public. No person14989
in the employ of the bureau, except those who are authorized by14990
the administrator of workers' compensation, shall divulge any14991
information secured by the person while in the employ of the14992
bureau in respect to the transactions, property, claim files,14993
records, or papers of the bureau or in respect to the business or14994
mechanical, chemical, or other industrial process of any company,14995
firm, corporation, person, association, partnership, or public14996
utility to any person other than the administrator or to the14997
superior of such employee of the bureau.14998

       Notwithstanding the restrictions imposed by this section, the14999
governor, select or standing committees of the general assembly,15000
the auditor of state, the attorney general, or their designees,15001
pursuant to the authority granted in this chapter and Chapter15002
4121. of the Revised Code, may examine any records, claim files,15003
or papers in possession of the industrial commission or the15004
bureau. They also are bound by the privilege that attaches to15005
these papers.15006

       The administrator shall report to the director of job and15007
family services or to the county director of job and family15008
services the name, address, and social security number or other15009
identification number of any person receiving workers'15010
compensation whose name or social security number or other15011
identification number is the same as that of a person required by15012
a court or child support enforcement agency to provide support15013
payments to a recipient or participant of public assistance, and15014
whose name is submitted to the administrator by the director under15015
section 5101.36 of the Revised Code. The administrator shall 15016
report to the director of health care administration or to the 15017
county director of job and family services the name, address, and 15018
social security number or other identification number of any 15019
person receiving workers' compensation whose name or social 15020
security number or other identification number is the same as that 15021
of a person required by a court or child support enforcement 15022
agency to provide support payments to a public medical assistance 15023
program recipient, and whose name is submitted to the 15024
administrator by the director under section 5160.42 of the Revised 15025
Code. The administrator also shall inform the appropriate director15026
of the amount of workers' compensation paid to the person during15027
such period as the director specifies.15028

       Within fourteen days after receiving from the director of job15029
and family services a list of the names and social security15030
numbers of recipients or participants of public assistance15031
pursuant to section 5101.181 of the Revised Code or a list of the 15032
names and social security numbers of public medical assistance 15033
program recipients pursuant to section 5160.43 of the Revised 15034
Code, the administrator shall inform the auditor of state of the 15035
name, current or most recent address, and social security number 15036
of each person receiving workers' compensation pursuant to this 15037
chapter whose name and social security number are the same as that 15038
of a person whose name or social security number was submitted by 15039
the directoris included in the list. The administrator also shall 15040
inform the auditor of state of the amount of workers' compensation 15041
paid to the person during such period as the director specifies.15042

       The bureau and its employees, except for purposes of15043
furnishing the auditor of state with information required by this15044
section, shall preserve the confidentiality of recipients or15045
participants of public assistance in compliance with division (A)15046
of section 5101.181 of the Revised Code and preserve the 15047
confidentiality of public medical assistance program recipients in 15048
compliance with section 5160.43 of the Revised Code.15049

       For the purposes of this section, "public assistance" means15050
medical assistance provided through the medical assistance program15051
established under section 5111.01 of the Revised Code, Ohio works15052
first provided under Chapter 5107. of the Revised Code,15053
prevention, retention, and contingency benefits and services15054
provided under Chapter 5108. of the Revised Code, disability 15055
financial assistance provided under Chapter 5115. of the Revised15056
Code, or the disability medical assistance provided under Chapter 15057
5115. of the Revised Codeprogram.15058

       Sec. 4141.162.  (A) The director of job and family services, 15059
in collaboration with the director of health care administration,15060
shall establish an income and eligibility verification system that15061
complies with section 1137 of the "Social Security Act." The15062
programs included in the system are all of the following:15063

       (1) Unemployment compensation pursuant to section 3304 of the 15064
"Internal Revenue Code of 1954";15065

       (2) The state programs funded in part under part A of Title15066
IV of the "Social Security Act" and administered under Chapters15067
5107. and 5108. of the Revised Code;15068

       (3) Medicaid pursuant to Title XIX of the "Social Security15069
Act";15070

       (4) Food stamps pursuant to the "Food Stamp Act of 1977," 9115071
Stat. 958, 7 U.S.C.A. 2011, as amended;15072

       (5) Any Ohio program under a plan approved under Title I, X,15073
XIV, or XVI of the "Social Security Act."15074

       Wage information provided by employers to the director shall15075
be furnished to the income and eligibility verification system. 15076
Such information shall be used by the director to determine15077
eligibility of individuals for unemployment compensation benefits15078
and the amount of those benefits and used by the agencies that15079
administer the programs identified in divisions (A)(2) to (5) of15080
this section to determine or verify eligibility for or the amount15081
of benefits under those programs.15082

       The director shall fully implement the use of wage15083
information to determine eligibility for and the amount of15084
unemployment compensation benefits by September 30, 1988.15085

       Information furnished under the system shall also be made15086
available to the appropriate state or local child support15087
enforcement agency for the purposes of an approved plan under15088
Title IV-D of the "Social Security Act" and to the appropriate15089
federal agency for the purposes of Titles II and XVI of the15090
"Social Security Act."15091

       (B) The director shall adopt rules as necessary under which15092
the department of job and family services and other state agencies15093
that the director determines must participate in order to ensure15094
compliance with section 1137 of the "Social Security Act" exchange15095
information with each other or authorized federal agencies about15096
individuals who are applicants for or recipients of benefits under15097
any of the programs enumerated in division (A) of this section.15098
The rules shall extend to all of the following:15099

       (1) A requirement for standardized formats and procedures for 15100
a participating agency to request and receive information about an 15101
individual, which information shall include the individual's 15102
social security number;15103

       (2) A requirement that all applicants for and recipients of15104
benefits under any program enumerated in division (A) of this15105
section be notified at the time of application, and periodically15106
thereafter, that information available through the system may be15107
shared with agencies that administer other benefit programs and15108
utilized in establishing or verifying eligibility or benefit15109
amounts under the other programs enumerated in division (A) of15110
this section;15111

       (3) A requirement that information is made available only to15112
the extent necessary to assist in the valid administrative needs15113
of the program receiving the information and is targeted for use15114
in ways which are most likely to be productive in identifying and15115
preventing ineligibility and incorrect payments;15116

       (4) A requirement that information is adequately protected15117
against unauthorized disclosures for purposes other than to15118
establish or verify eligibility or benefit amounts under the15119
programs enumerated in division (A) of this section;15120

       (5) A requirement that a program providing information is15121
reimbursed by the program using the information for the actual15122
costs of furnishing the information and that the director be15123
reimbursed by the participating programs for any actual costs15124
incurred in operating the system;15125

       (6) Requirements for any other matters necessary to ensure15126
the effective, efficient, and timely exchange of necessary15127
information or that the director determines must be addressed in15128
order to ensure compliance with the requirements of section 113715129
of the "Social Security Act."15130

       (C) Each participating agency shall furnish to the income and 15131
eligibility verification system established in division (A) of15132
this section that information, which the director, by rule,15133
determines is necessary in order to comply with section 1137 of15134
the "Social Security Act."15135

       (D) Notwithstanding the information disclosure requirements15136
of this section and section 4141.21 and division (A) of section 15137
4141.284 of the Revised Code, the director shall administer those15138
provisions of law so as to comply with section 1137 of the "Social15139
Security Act."15140

       (E) Requirements in section 4141.21 of the Revised Code with15141
respect to confidentiality of information obtained in the15142
administration of Chapter 4141. of the Revised Code and any15143
sanctions imposed for improper disclosure of such information15144
shall apply to the redisclosure of information disclosed under15145
this section.15146

       Sec. 4719.01.  (A) As used in sections 4719.01 to 4719.18 of15147
the Revised Code:15148

       (1) "Affiliate" means a business entity that is owned by,15149
operated by, controlled by, or under common control with another15150
business entity.15151

       (2) "Communication" means a written or oral notification or15152
advertisement that meets both of the following criteria, as15153
applicable:15154

       (a) The notification or advertisement is transmitted by or on 15155
behalf of the seller of goods or services and by or through any15156
printed, audio, video, cinematic, telephonic, or electronic means.15157

       (b) In the case of a notification or advertisement other than 15158
by telephone, either of the following conditions is met:15159

       (i) The notification or advertisement is followed by a15160
telephone call from a telephone solicitor or salesperson.15161

       (ii) The notification or advertisement invites a response by15162
telephone, and, during the course of that response, a telephone15163
solicitor or salesperson attempts to make or makes a sale of goods15164
or services. As used in division (A)(2)(b)(ii) of this section,15165
"invites a response by telephone" excludes the mere listing or15166
inclusion of a telephone number in a notification or15167
advertisement.15168

       (3) "Gift, award, or prize" means anything of value that is15169
offered or purportedly offered, or given or purportedly given by15170
chance, at no cost to the receiver and with no obligation to15171
purchase goods or services. As used in this division, "chance"15172
includes a situation in which a person is guaranteed to receive an15173
item and, at the time of the offer or purported offer, the15174
telephone solicitor does not identify the specific item that the15175
person will receive.15176

       (4) "Goods or services" means any real property or any15177
tangible or intangible personal property, or services of any kind15178
provided or offered to a person. "Goods or services" includes, but15179
is not limited to, advertising; labor performed for the benefit of15180
a person; personal property intended to be attached to or15181
installed in any real property, regardless of whether it is so15182
attached or installed; timeshare estates or licenses; and extended15183
service contracts.15184

       (5) "Purchaser" means a person that is solicited to become or15185
does become financially obligated as a result of a telephone15186
solicitation.15187

       (6) "Salesperson" means an individual who is employed,15188
appointed, or authorized by a telephone solicitor to make15189
telephone solicitations but does not mean any of the following:15190

       (a) An individual who comes within one of the exemptions in15191
division (B) of this section;15192

       (b) An individual employed, appointed, or authorized by a15193
person who comes within one of the exemptions in division (B) of15194
this section;15195

       (c) An individual under a written contract with a person who15196
comes within one of the exemptions in division (B) of this15197
section, if liability for all transactions with purchasers is15198
assumed by the person so exempted.15199

       (7) "Telephone solicitation" means a communication to a15200
person that meets both of the following criteria:15201

       (a) The communication is initiated by or on behalf of a15202
telephone solicitor or by a salesperson.15203

       (b) The communication either represents a price or the15204
quality or availability of goods or services or is used to induce15205
the person to purchase goods or services, including, but not15206
limited to, inducement through the offering of a gift, award, or15207
prize.15208

       (8) "Telephone solicitor" means a person that engages in15209
telephone solicitation directly or through one or more15210
salespersons either from a location in this state, or from a15211
location outside this state to persons in this state. "Telephone15212
solicitor" includes, but is not limited to, any such person that15213
is an owner, operator, officer, or director of, partner in, or15214
other individual engaged in the management activities of, a15215
business.15216

       (B) A telephone solicitor is exempt from the provisions of15217
sections 4719.02 to 4719.18 and section 4719.99 of the Revised15218
Code if the telephone solicitor is any one of the following:15219

       (1) A person engaging in a telephone solicitation that is a15220
one-time or infrequent transaction not done in the course of a15221
pattern of repeated transactions of a like nature;15222

       (2) A person engaged in telephone solicitation solely for15223
religious or political purposes; a charitable organization,15224
fund-raising counsel, or professional solicitor in compliance with15225
the registration and reporting requirements of Chapter 1716. of15226
the Revised Code; or any person or other entity exempt under15227
section 1716.03 of the Revised Code from filing a registration15228
statement under section 1716.02 of the Revised Code;15229

       (3) A person, making a telephone solicitation involving a15230
home solicitation sale as defined in section 1345.21 of the15231
Revised Code, that makes the sales presentation and completes the15232
sale at a later, face-to-face meeting between the seller and the15233
purchaser rather than during the telephone solicitation. However,15234
if the person, following the telephone solicitation, causes15235
another person to collect the payment of any money, this exemption15236
does not apply.15237

       (4) A licensed securities, commodities, or investment broker, 15238
dealer, investment advisor, or associated person when making a 15239
telephone solicitation within the scope of the person's license. 15240
As used in division (B)(4) of this section, "licensed securities,15241
commodities, or investment broker, dealer, investment advisor, or 15242
associated person" means a person subject to licensure or 15243
registration as such by the securities and exchange commission;15244
the National Association of Securities Dealers or other15245
self-regulatory organization, as defined by 15 U.S.C.A. 78c; by15246
the division of securities under Chapter 1707. of the Revised15247
Code; or by an official or agency of any other state of the United15248
States.15249

       (5)(a) A person primarily engaged in soliciting the sale of a15250
newspaper of general circulation;15251

       (b) As used in division (B)(5)(a) of this section, "newspaper 15252
of general circulation" includes, but is not limited to, both of 15253
the following:15254

       (i) A newspaper that is a daily law journal designated as an15255
official publisher of court calendars pursuant to section 2701.0915256
of the Revised Code;15257

       (ii) A newspaper or publication that has at least twenty-five 15258
per cent editorial, non-advertising content, exclusive of inserts, 15259
measured relative to total publication space, and an audited 15260
circulation to at least fifty per cent of the households in the 15261
newspaper's retail trade zone as defined by the audit.15262

       (6)(a) An issuer, or its subsidiary, that has a class of15263
securities to which all of the following apply:15264

       (i) The class of securities is subject to section 12 of the15265
"Securities Exchange Act of 1934," 15 U.S.C.A. 78l, and is15266
registered or is exempt from registration under 15 U.S.C.A.15267
78l(g)(2)(A), (B), (C), (E), (F), (G), or (H);15268

       (ii) The class of securities is listed on the New York stock15269
exchange, the American stock exchange, or the NASDAQ national15270
market system;15271

       (iii) The class of securities is a reported security as15272
defined in 17 C.F.R. 240.11Aa3-1(a)(4).15273

       (b) An issuer, or its subsidiary, that formerly had a class15274
of securities that met the criteria set forth in division15275
(B)(6)(a) of this section if the issuer, or its subsidiary, has a15276
net worth in excess of one hundred million dollars, files or its15277
parent files with the securities and exchange commission an S.E.C.15278
form 10-K, and has continued in substantially the same business15279
since it had a class of securities that met the criteria in15280
division (B)(6)(a) of this section. As used in division (B)(6)(b)15281
of this section, "issuer" and "subsidiary" include the successor15282
to an issuer or subsidiary.15283

       (7) A person soliciting a transaction regulated by the15284
commodity futures trading commission, if the person is registered15285
or temporarily registered for that activity with the commission15286
under 7 U.S.C.A. 1 et. seq. and the registration or temporary15287
registration has not expired or been suspended or revoked;15288

       (8) A person soliciting the sale of any book, record, audio15289
tape, compact disc, or video, if the person allows the purchaser15290
to review the merchandise for at least seven days and provides a15291
full refund within thirty days to a purchaser who returns the15292
merchandise or if the person solicits the sale on behalf of a15293
membership club operating in compliance with regulations adopted15294
by the federal trade commission in 16 C.F.R. 425;15295

       (9) A supervised financial institution or its subsidiary. As15296
used in division (B)(9) of this section, "supervised financial15297
institution" means a bank, trust company, savings and loan15298
association, savings bank, credit union, industrial loan company,15299
consumer finance lender, commercial finance lender, or institution15300
described in section 2(c)(2)(F) of the "Bank Holding Company Act15301
of 1956," 12 U.S.C.A. 1841(c)(2)(F), as amended, supervised by an15302
official or agency of the United States, this state, or any other15303
state of the United States; or a licensee or registrant under15304
sections 1321.01 to 1321.19, 1321.51 to 1321.60, or 1321.71 to15305
1321.83 of the Revised Code.15306

       (10)(a) An insurance company, association, or other15307
organization that is licensed or authorized to conduct business in15308
this state by the superintendent of insurance pursuant to Title15309
XXXIX of the Revised Code or Chapter 1751. of the Revised Code,15310
when soliciting within the scope of its license or authorization.15311

       (b) A licensed insurance broker, agent, or solicitor when15312
soliciting within the scope of the person's license. As used in15313
division (B)(10)(b) of this section, "licensed insurance broker,15314
agent, or solicitor" means any person licensed as an insurance15315
broker, agent, or solicitor by the superintendent of insurance15316
pursuant to Title XXXIX of the Revised Code.15317

       (11) A person soliciting the sale of services provided by a15318
cable television system operating under authority of a15319
governmental franchise or permit;15320

       (12) A person soliciting a business-to-business sale under15321
which any of the following conditions are met:15322

       (a) The telephone solicitor has been operating continuously15323
for at least three years under the same business name under which15324
it solicits purchasers, and at least fifty-one per cent of its15325
gross dollar volume of sales consists of repeat sales to existing15326
customers to whom it has made sales under the same business name.15327

       (b) The purchaser business intends to resell the goods15328
purchased.15329

       (c) The purchaser business intends to use the goods or15330
services purchased in a recycling, reuse, manufacturing, or15331
remanufacturing process.15332

       (d) The telephone solicitor is a publisher of a periodical or 15333
of magazines distributed as controlled circulation publications as15334
defined in division (CC) of section 5739.01 of the Revised Code15335
and is soliciting sales of advertising, subscriptions, reprints,15336
lists, information databases, conference participation or15337
sponsorships, trade shows or media products related to the15338
periodical or magazine, or other publishing services provided by15339
the controlled circulation publication.15340

       (13) A person that, not less often than once each year,15341
publishes and delivers to potential purchasers a catalog that15342
complies with both of the following:15343

       (a) It includes all of the following:15344

       (i) The business address of the seller;15345

       (ii) A written description or illustration of each good or15346
service offered for sale;15347

       (iii) A clear and conspicuous disclosure of the sale price of15348
each good or service; shipping, handling, and other charges; and 15349
return policy;15350

       (b) One of the following applies:15351

       (i) The catalog includes at least twenty-four pages of15352
written material and illustrations, is distributed in more than15353
one state, and has an annual postage-paid mail circulation of not15354
less than two hundred fifty thousand households;15355

       (ii) The catalog includes at least ten pages of written15356
material or an equivalent amount of material in electronic form on15357
the internet or an on-line computer service, the person does not15358
solicit customers by telephone but solely receives telephone calls15359
made in response to the catalog, and during the calls the person15360
takes orders but does not engage in further solicitation of the15361
purchaser. As used in division (B)(13)(b)(ii) of this section,15362
"further solicitation" does not include providing the purchaser15363
with information about, or attempting to sell, any other item in15364
the catalog that prompted the purchaser's call or in a15365
substantially similar catalog issued by the seller.15366

       (14) A political subdivision or instrumentality of the United 15367
States, this state, or any state of the United States;15368

       (15) A college or university or any other public or private15369
institution of higher education in this state;15370

       (16) A public utility as defined in section 4905.02 of the15371
Revised Code or a retail natural gas supplier as defined in15372
section 4929.01 of the Revised Code, if the utility or supplier is 15373
subject to regulation by the public utilities commission, or the 15374
affiliate of the utility or supplier;15375

       (17) A person that solicits sales through a television15376
program or advertisement that is presented in the same market area15377
no fewer than twenty days per month or offers for sale no fewer15378
than ten distinct items of goods or services; and offers to the15379
purchaser an unconditional right to return any good or service15380
purchased within a period of at least seven days and to receive a15381
full refund within thirty days after the purchaser returns the15382
good or cancels the service;15383

       (18)(a) A person that, for at least one year, has been15384
operating a retail business under the same name as that used in15385
connection with telephone solicitation and both of the following15386
occur on a continuing basis:15387

       (i) The person either displays goods and offers them for15388
retail sale at the person's business premises or offers services15389
for sale and provides them at the person's business premises.15390

       (ii) At least fifty-one per cent of the person's gross dollar 15391
volume of retail sales involves purchases of goods or services at15392
the person's business premises.15393

       (b) An affiliate of a person that meets the requirements in15394
division (B)(18)(a) of this section if the affiliate meets all of15395
the following requirements:15396

       (i) The affiliate has operated a retail business for a period 15397
of less than one year;15398

       (ii) The affiliate either displays goods and offers them for15399
retail sale at the affiliate's business premises or offers15400
services for sale and provides them at the affiliate's business15401
premises;15402

       (iii) At least fifty-one per cent of the affiliate's gross15403
dollar volume of retail sales involves purchases of goods or15404
services at the affiliate's business premises.15405

       (c) A person that, for a period of less than one year, has15406
been operating a retail business in this state under the same name15407
as that used in connection with telephone solicitation, as long as15408
all of the following requirements are met:15409

       (i) The person either displays goods and offers them for15410
retail sale at the person's business premises or offers services15411
for sale and provides them at the person's business premises;15412

       (ii) The goods or services that are the subject of telephone15413
solicitation are sold at the person's business premises, and at15414
least sixty-five per cent of the person's gross dollar volume of15415
retail sales involves purchases of goods or services at the15416
person's business premises;15417

       (iii) The person conducts all telephone solicitation15418
activities according to sections 310.3, 310.4, and 310.5 of the15419
telemarketing sales rule adopted by the federal trade commission15420
in 16 C.F.R. part 310.15421

       (19) A person who performs telephone solicitation sales15422
services on behalf of other persons and to whom one of the15423
following applies:15424

       (a) The person has operated under the same ownership,15425
control, and business name for at least five years, and the person15426
receives at least seventy-five per cent of its gross revenues from15427
written telephone solicitation contracts with persons who come15428
within one of the exemptions in division (B) of this section.15429

       (b) The person is an affiliate of one or more exempt persons15430
and makes telephone solicitations on behalf of only the exempt15431
persons of which it is an affiliate.15432

       (c) The person makes telephone solicitations on behalf of15433
only exempt persons, the person and each exempt person on whose15434
behalf telephone solicitations are made have entered into a15435
written contract that specifies the manner in which the telephone15436
solicitations are to be conducted and that at a minimum requires15437
compliance with the telemarketing sales rule adopted by the15438
federal trade commission in 16 C.F.R. part 310, and the person15439
conducts the telephone solicitations in the manner specified in15440
the written contract.15441

       (d) The person performs telephone solicitation for religious15442
or political purposes, a charitable organization, a fund-raising15443
council, or a professional solicitor in compliance with the15444
registration and reporting requirements of Chapter 1716. of the15445
Revised Code; and meets all of the following requirements:15446

       (i) The person has operated under the same ownership,15447
control, and business name for at least five years, and the person15448
receives at least fifty-one per cent of its gross revenues from15449
written telephone solicitation contracts with persons who come15450
within the exemption in division (B)(2) of this section;15451

       (ii) The person does not conduct a prize promotion or offer15452
the sale of an investment opportunity; 15453

       (iii) The person conducts all telephone solicitation15454
activities according to sections 310.3, 310.4, and 310.5 of the15455
telemarketing sales rules adopted by the federal trade commission15456
in 16 C.F.R. part 310.15457

       (20) A person that is a licensed real estate salesperson or15458
broker under Chapter 4735. of the Revised Code when soliciting15459
within the scope of the person's license;15460

       (21)(a) Either of the following:15461

       (i) A publisher that solicits the sale of the publisher's15462
periodical or magazine of general, paid circulation, or a person15463
that solicits a sale of that nature on behalf of a publisher under15464
a written agreement directly between the publisher and the person.15465

       (ii) A publisher that solicits the sale of the publisher's15466
periodical or magazine of general, paid circulation, or a person15467
that solicits a sale of that nature as authorized by a publisher15468
under a written agreement directly with a publisher's15469
clearinghouse provided the person is a resident of Ohio for more15470
than three years and initiates all telephone solicitations from15471
Ohio and the person conducts the solicitation and sale in15472
compliance with 16 C.F.R. part 310, as adopted by the federal15473
trade commission.15474

       (b) As used in division (B)(21) of this section, "periodical15475
or magazine of general, paid circulation" excludes a periodical or15476
magazine circulated only as part of a membership package or given15477
as a free gift or prize from the publisher or person.15478

       (22) A person that solicits the sale of food, as defined in15479
section 3715.01 of the Revised Code, or the sale of products of15480
horticulture, as defined in section 5739.01 of the Revised Code,15481
if the person does not intend the solicitation to result in, or15482
the solicitation actually does not result in, a sale that costs15483
the purchaser an amount greater than five hundred dollars.15484

       (23) A funeral director licensed pursuant to Chapter 4717. of 15485
the Revised Code when soliciting within the scope of that license, 15486
if both of the following apply:15487

       (a) The solicitation and sale are conducted in compliance15488
with 16 C.F.R. part 453, as adopted by the federal trade15489
commission, and with sections 1107.33 and 1345.21 to 1345.28 of15490
the Revised Code;15491

       (b) The person provides to the purchaser of any preneed15492
funeral contract a notice that clearly and conspicuously sets15493
forth the cancellation rights specified in division (G) of section15494
1107.33 of the Revised Code, and retains a copy of the notice15495
signed by the purchaser.15496

       (24) A person, or affiliate thereof, licensed to sell or15497
issue Ohio instruments designated as travelers checks pursuant to15498
sections 1315.01 to 1315.18 of the Revised Code.15499

       (25) A person that solicits sales from its previous15500
purchasers and meets all of the following requirements:15501

       (a) The solicitation is made under the same business name15502
that was previously used to sell goods or services to the15503
purchaser;15504

       (b) The person has, for a period of not less than three15505
years, operated a business under the same business name as that15506
used in connection with telephone solicitation;15507

       (c) The person does not conduct a prize promotion or offer15508
the sale of an investment opportunity;15509

       (d) The person conducts all telephone solicitation activities15510
according to sections 310.3, 310.4, and 310.5 of the telemarketing 15511
sales rules adopted by the federal trade commission in 16 C.F.R. 15512
part 310;15513

       (e) Neither the person nor any of its principals has been15514
convicted of, pleaded guilty to, or has entered a plea of no15515
contest for a felony or a theft offense as defined in sections15516
2901.02 and 2913.01 of the Revised Code or similar law of another15517
state or of the United States;15518

       (f) Neither the person nor any of its principals has had15519
entered against them an injunction or a final judgment or order,15520
including an agreed judgment or order, an assurance of voluntary15521
compliance, or any similar instrument, in any civil or15522
administrative action involving engaging in a pattern of corrupt15523
practices, fraud, theft, embezzlement, fraudulent conversion, or15524
misappropriation of property; the use of any untrue, deceptive, or15525
misleading representation; or the use of any unfair, unlawful,15526
deceptive, or unconscionable trade act or practice.15527

       (26) An institution defined as a home health agency in15528
section 3701.881 of the Revised Code, that conducts all telephone15529
solicitation activities according to sections 310.3, 310.4, and15530
310.5 of the telemarketing sales rules adopted by the federal15531
trade commission in 16 C.F.R. part 310, and engages in telephone15532
solicitation only within the scope of the institution's15533
certification, accreditation, contract with the department of15534
aging, or status as a home health agency; and that meets one of15535
the following requirements:15536

       (a) The institution is certified as a provider of home health15537
services under Title XVIII of the Social Security Act, 49 Stat. 15538
620, 42 U.S.C. 301, as amendedmedicare program;15539

       (b) The institution is accredited by either the joint15540
commission on accreditation of health care organizations or the15541
community health accreditation program;15542

       (c) The institution is providing passport services under the15543
direction of the Ohio department of aging under section 173.40 of15544
the Revised Code;15545

       (d) An affiliate of an institution that meets the15546
requirements of division (B)(26)(a), (b), or (c) of this section15547
when offering for sale substantially the same goods and services15548
as those that are offered by the institution that meets the15549
requirements of division (B)(26)(a), (b), or (c) of this section.15550

       (27) A person licensed to provide a hospice care program by15551
the department of health pursuant to section 3712.04 of the15552
Revised Code when conducting telephone solicitations within the15553
scope of the person's license and according to sections 310.3,15554
310.4, and 310.5 of the telemarketing sales rules adopted by the15555
federal trade commission in 16 C.F.R. part 310.15556

       Sec. 4723.063.  (A) As used in this section: 15557

       (1) "Health care facility" means:15558

       (a) A hospital registered under section 3701.07 of the 15559
Revised Code;15560

       (b) A nursing home licensed under section 3721.02 of the 15561
Revised Code, or by a political subdivision certified under 15562
section 3721.09 of the Revised Code;15563

       (c) A county home or a county nursing home as defined in 15564
section 5155.31 of the Revised Code that is certified under Title 15565
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 15566
U.S.C. 301, amendedmedicare program or medicaid program;15567

       (d) A freestanding dialysis center;15568

       (e) A freestanding inpatient rehabilitation facility;15569

       (f) An ambulatory surgical facility;15570

       (g) A freestanding cardiac catheterization facility;15571

       (h) A freestanding birthing center;15572

       (i) A freestanding or mobile diagnostic imaging center;15573

       (j) A freestanding radiation therapy center.15574

       (2) "Nurse education program" means a prelicensure nurse 15575
education program approved by the board of nursing under section 15576
4723.06 of the Revised Code or a postlicensure nurse education 15577
program approved by the board of regents under section 3333.04 of 15578
the Revised Code.15579

       (B) The state board of nursing shall establish and administer 15580
the nurse education grant program. Under the program, the board 15581
shall award grants to nurse education programs that have 15582
partnerships with other education programs, community health 15583
agencies, or health care facilities. Grant recipients shall use 15584
the money to fund partnerships to increase the nurse education 15585
program's enrollment capacity. Methods of increasing a program's 15586
enrollment capacity may include hiring faculty and preceptors, 15587
purchasing educational equipment and materials, and other actions 15588
acceptable to the board. Grant money shall not be used to 15589
construct or renovate buildings. Partnerships may be developed 15590
between one or more nurse education programs and one or more 15591
health care facilities.15592

       In awarding grants, the board shall give preference to 15593
partnerships between nurse education programs and hospitals, 15594
nursing homes, and county homes or county nursing homes, but may 15595
also award grants to fund partnerships between nurse education 15596
programs and other health care facilities.15597

       (C) The board shall adopt rules in accordance with Chapter 15598
119. of the Revised Code establishing the following:15599

       (1) Eligibility requirements for receipt of a grant;15600

       (2) Grant application forms and procedures;15601

       (3) The amounts in which grants may be made and the total 15602
amount that may be awarded to a nurse education program that has a 15603
partnership with other education programs, a community health 15604
agency, or a health care facility;15605

       (4) A method whereby the board may evaluate the effectiveness 15606
of a partnership between joint recipients in increasing the nurse 15607
education program's enrollment capacity;15608

       (5) The percentage of the money in the fund that must remain 15609
in the fund at all times to maintain a fiscally responsible fund 15610
balance;15611

       (6) The percentage of available grants to be awarded to 15612
licensed practical nurse education programs, registered nurse 15613
education programs, and graduate programs;15614

       (7) Any other matters incidental to the operation of the 15615
program. 15616

       (D) From January 1, 2004, until December 31, 2013, the ten 15617
dollars of each biennial nursing license renewal fee collected 15618
under section 4723.08 of the Revised Code shall be dedicated to 15619
the nurse education grant program fund, which is hereby created in 15620
the state treasury. The board shall use money in the fund for 15621
grants awarded under division (A) of this section and for expenses 15622
of administering the grant program. The amount used for 15623
administrative expenses in any year shall not exceed ten per cent 15624
of the amount transferred to the fund in that year.15625

       (E) Each quarter, for the purposes of transferring funds to 15626
the nurse education grant program, the board of nursing shall 15627
certify to the director of budget and management the number of 15628
biennial licenses renewed under this chapter during the preceding 15629
quarter and the amount equal to that number times ten dollars.15630

       (F) Notwithstanding the requirements of section 4743.05 of 15631
the Revised Code, from January 1, 2004, until December 31, 2013, 15632
at the end of each quarter, the director of budget and management 15633
shall transfer from the occupational licensing and regulatory fund 15634
to the nurse education grant program fund the amount certified 15635
under division (E) of this section.15636

       Sec. 4723.17.  (A) The board of nursing may authorize a15637
licensed practical nurse to administer to an adult intravenous15638
therapy authorized by an individual who is authorized to practice15639
in this state and is acting within the course of the individual's15640
professional practice, if the licensed practical nurse has a 15641
current, valid license issued under this chapter that includes 15642
authorization to administer medications and one of the following 15643
is the case:15644

       (1) The nurse has successfully completed, within a practical 15645
nurse prelicensure education program approved by the board or by 15646
another jurisdiction's agency that regulates the practice of 15647
nursing, a course of study that prepares the nurse to safely 15648
perform the intravenous therapy procedures the board may authorize 15649
under this section. To meet this requirement, the course of study 15650
must include all of the following:15651

       (a) Both didactic and clinical components;15652

       (b) Curriculum requirements established in rules the board of 15653
nursing shall adopt in accordance with Chapter 119. of the Revised 15654
Code;15655

       (c) Standards that require the nurse to perform a successful 15656
demonstration of the intravenous procedures, including all skills 15657
needed to perform them safely.15658

       (2) The nurse has successfully completed a minimum of forty 15659
hours of training that includes all of the following:15660

       (a) The curriculum established by rules adopted by the board15661
and in effect on January 1, 1999;15662

       (b) Training in the anatomy and physiology of the15663
cardiovascular system, signs and symptoms of local and systemic15664
complications in the administration of fluids and antibiotic15665
additives, and guidelines for management of these complications;15666

       (c) Any other training or instruction the board considers15667
appropriate.15668

       (d) A testing component that requires the nurse to perform a 15669
successful demonstration of the intravenous procedures, including 15670
all skills needed to perform them safely.15671

       (B) Except as provided in section 4723.171 of the Revised15672
Code, a licensed practical nurse may perform intravenous therapy15673
only if authorized by the board pursuant to division (A) of this15674
section and only if it is performed in accordance with this15675
section.15676

       A licensed practical nurse authorized by the board to perform15677
intravenous therapy may perform an intravenous therapy procedure15678
only at the direction of one of the following:15679

       (1) A licensed physician, dentist, optometrist, or podiatrist 15680
who, except as provided in division (C)(2) of this section, is15681
present and readily available at the facility where the 15682
intravenous therapy procedure is performed;15683

       (2) A registered nurse in accordance with division (C) of15684
this section.15685

       (C)(1) Except as provided in division (C)(2) of this section15686
and section 4723.171 of the Revised Code, when a licensed15687
practical nurse authorized by the board to perform intravenous15688
therapy performs an intravenous therapy procedure at the direction15689
of a registered nurse, the registered nurse or another registered15690
nurse shall be readily available at the site where the intravenous15691
therapy is performed, and before the licensed practical nurse15692
initiates the intravenous therapy, the registered nurse shall15693
personally perform an on-site assessment of the individual who is15694
to receive the intravenous therapy.15695

       (2) When a licensed practical nurse authorized by the board15696
to perform intravenous therapy performs an intravenous therapy15697
procedure in a home as defined in section 3721.10 of the Revised15698
Code, or in an intermediate care facility for the mentally15699
retarded as defined in section 5111.205164.01 of the Revised 15700
Code, at the direction of a registered nurse or licensed 15701
physician, dentist, optometrist, or podiatrist, a registered nurse 15702
shall be on the premises of the home or facility or accessible by 15703
some form of telecommunication.15704

       (D) No licensed practical nurse shall perform any of the15705
following intravenous therapy procedures:15706

       (1) Initiating or maintaining any of the following:15707

       (a) Blood or blood components;15708

       (b) Solutions for total parenteral nutrition;15709

       (c) Any cancer therapeutic medication including, but not15710
limited to, cancer chemotherapy or an anti-neoplastic agent;15711

       (d) Solutions administered through any central venous line or15712
arterial line or any other line that does not terminate in a15713
peripheral vein, except that a licensed practical nurse authorized15714
by the board to perform intravenous therapy may maintain the15715
solutions specified in division (D)(6)(a) of this section that are15716
being administered through a central venous line or peripherally15717
inserted central catheter;15718

       (e) Any investigational or experimental medication.15719

       (2) Initiating intravenous therapy in any vein, except that a 15720
licensed practical nurse authorized by the board to perform15721
intravenous therapy may initiate intravenous therapy in accordance15722
with this section in a vein of the hand, forearm, or antecubital15723
fossa;15724

       (3) Discontinuing a central venous, arterial, or any other15725
line that does not terminate in a peripheral vein;15726

       (4) Initiating or discontinuing a peripherally inserted15727
central catheter;15728

       (5) Mixing, preparing, or reconstituting any medication for15729
intravenous therapy, except that a licensed practical nurse15730
authorized by the board to perform intravenous therapy may prepare15731
or reconstitute an antibiotic additive;15732

       (6) Administering medication via the intravenous route,15733
including all of the following activities:15734

       (a) Adding medication to an intravenous solution or to an15735
existing infusion, except that a licensed practical nurse15736
authorized by the board to perform intravenous therapy may do15737
either of the following:15738

       (i) Initiate an intravenous infusion containing one or more15739
of the following elements: dextrose 5%; normal saline; lactated15740
ringers; sodium chloride .45%; sodium chloride 0.2%; sterile15741
water.15742

       (ii) Hang subsequent containers of the intravenous solutions15743
specified in division (D)(6)(a) of this section that contain15744
vitamins or electrolytes, if a registered nurse initiated the15745
infusion of that same intravenous solution.15746

       (b) Initiating or maintaining an intravenous piggyback15747
infusion, except that a licensed practical nurse authorized by the15748
board to perform intravenous therapy may initiate or maintain an15749
intravenous piggyback infusion containing an antibiotic additive;15750

       (c) Injecting medication via a direct intravenous route,15751
except that a licensed practical nurse authorized by the board to15752
perform intravenous therapy may inject heparin or normal saline to15753
flush an intermittent infusion device or heparin lock including,15754
but not limited to, bolus or push.15755

       (7) Aspirating any intravenous line to maintain patency;15756

       (8) Changing tubing on any line including, but not limited15757
to, an arterial line or a central venous line, except that a15758
licensed practical nurse authorized by the board to perform15759
intravenous therapy may change tubing on an intravenous line that15760
terminates in a peripheral vein;15761

       (9) Programming or setting any function of a patient15762
controlled infusion pump.15763

       (E) Notwithstanding division (D) of this section, at the15764
direction of a physician or a registered nurse, a licensed15765
practical nurse authorized by the board to perform intravenous15766
therapy may perform the following activities for the purpose of15767
performing dialysis:15768

       (1) The routine administration and regulation of saline15769
solution for the purpose of maintaining an established fluid plan;15770

       (2) The administration of a heparin dose intravenously;15771

       (3) The administration of a heparin dose peripherally via a15772
fistula needle;15773

       (4) The loading and activation of a constant infusion pump or 15774
the intermittent injection of a dose of medication prescribed by a 15775
licensed physician for dialysis.15776

       (F) No person shall employ or direct a licensed practical15777
nurse to perform an intravenous therapy procedure without first15778
verifying that the licensed practical nurse is authorized by the15779
board to perform intravenous therapy.15780

       (G) The board shall issue an intravenous therapy card to the 15781
licensed practical nurses authorized pursuant to division (A) of 15782
this section to perform intravenous therapy. A fee for issuing the 15783
card shall not be charged under section 4723.08 of the Revised 15784
Code if the licensed practical nurse receives the card by meeting 15785
the requirements of division (A)(1) of this section. The board 15786
shall maintain a registry of the names of licensed practical 15787
nurses who hold intravenous therapy cards.15788

       Sec. 4723.63.  (A) In consultation with the medication aide 15789
advisory council established under section 4723.62 of the Revised 15790
Code, the board of nursing shall conduct a pilot program for the 15791
use of medication aides in nursing homes and residential care 15792
facilities. The board shall conduct the pilot program in a manner 15793
consistent with human protection and other ethical concerns 15794
typically associated with research studies involving live 15795
subjects. The pilot program shall be commenced not later than May 15796
1, 2006, and shall end on the thirty-first day after the report 15797
required by division (F)(2) of this section is submitted in 15798
accordance with that division.15799

        During the period the pilot program is conducted, a nursing 15800
home or residential care facility participating in the pilot 15801
program may use one or more medication aides to administer 15802
prescription medications to its residents, subject to all of the 15803
following conditions:15804

        (1) Each individual used as a medication aide must hold a 15805
current, valid medication aide certificate issued by the board of 15806
nursing under this chapter.15807

        (2) The nursing home or residential care facility shall 15808
ensure that the requirements of section 4723.67 of the Revised 15809
Code are met.15810

       (3) The nursing home or residential care facility shall 15811
submit to the board, not later than the thirty-first day after the 15812
day the board makes its request under division (F)(1)(a) of this 15813
section, the data required by division (F)(1)(a) of this section.15814

       (B) The board, in consultation with the medication aide 15815
advisory council, shall do all of the following not later than 15816
February 1, 2006:15817

       (1) Design the pilot program;15818

       (2) Establish standards to govern medication aides and the 15819
nursing homes and residential care facilities participating in the 15820
pilot program, including standards for the training of medication 15821
aides and the staff of participating nursing homes and residential 15822
care facilities;15823

       (3) Establish standards to protect the health and safety of 15824
the residents of the nursing homes and residential care facilities 15825
participating in the program;15826

       (4) Implement a process for selecting the nursing homes and 15827
residential care facilities to participate in the program.15828

       (C)(1) A nursing home or residential care facility may 15829
volunteer to participate in the pilot program by submitting an 15830
application to the board on a form prescribed and provided by the 15831
board. From among the applicants, the board shall select eighty 15832
nursing homes and forty residential care facilities to participate 15833
in the pilot program. When the board denies an application, it 15834
shall notify, in writing, the president and minority leader of the 15835
senate and the speaker and minority leader of the house of 15836
representatives of the denial and the reasons for the denial.15837

       (2) To be eligible to participate, a nursing home or 15838
residential care facility shall agree to observe the standards 15839
established by the board for the use of medication aides. A 15840
nursing home is eligible to participate only if the department of 15841
health has found in the most recent survey or inspection of the 15842
home that the home is free from deficiencies related to the 15843
administration of medication. A residential care facility is 15844
eligible to participate only if the department has found that the 15845
facility is free from deficiencies related to the provision of 15846
skilled nursing care or the administration of medication.15847

       (D) As a condition of participation in the pilot program, a 15848
nursing home and residential care facility selected by the board 15849
shall pay the participation fee established in rules adopted under 15850
section 4723.69 of the Revised Code. The participation fee is not 15851
reimbursable under the medicaid program established under Chapter 15852
5111. of the Revised Code.15853

       (E) On receipt of evidence found credible by the board that 15854
continued participation by a nursing home or residential care 15855
facility poses an imminent danger, risk of serious harm, or 15856
jeopardy to a resident of the home or facility, the board may 15857
terminate the authority of the home or facility to participate in 15858
the pilot program.15859

       (F)(1) With the assistance of the medication aide advisory 15860
council, the board shall conduct an evaluation of the pilot 15861
program. In conducting the evaluation, the board shall do all of 15862
the following:15863

       (a) Request from each nursing home and residential care 15864
facility participating in the pilot program, on the ninety-first 15865
day after the day the board issues a medication aide certificate 15866
under section 4723.651 of the Revised Code to the seventy-fifth 15867
individual, the data the board requires participating nursing 15868
homes and residential care facilities to report under rules the 15869
board adopts under section 4723.69 of the Revised Code.15870

       (b) Assess whether medication aides are able to administer 15871
prescription medications safely to nursing home and residential 15872
care facility residents;15873

       (c) Determine the financial implications of using medication 15874
aides in nursing homes and residential care facilities;15875

       (d) Consider any other issue the board or council considers 15876
relevant to the evaluation.15877

       (2) Not later than the one hundred eighty-first day after 15878
the day the board issues a medication aide certificate under 15879
section 4723.651 of the Revised Code to the seventy-fifth 15880
individual, the board shall prepare a report of its findings and 15881
recommendations derived from the evaluation of the pilot program. 15882
The board shall submit the report to the governor, president and 15883
minority leader of the senate, speaker and minority leader of the 15884
house of representatives, and director of health.15885

       (G) The board shall, on the day it issues a medication aide 15886
certificate to the seventy-fifth individual, post a notice on its 15887
web site indicating the date on which any nursing home or 15888
residential care facility may use medication aides in accordance 15889
with section 4723.64 of the Revised Code.15890

       Sec. 4731.151.  (A) Naprapaths who received a certificate to 15891
practice from the board prior to March 2, 1992, may continue to 15892
practice naprapathy, as defined in rules adopted by the board. 15893
Such naprapaths shall practice in accordance with rules adopted by 15894
the board.15895

       (B)(1) As used in this division:15896

       (a) "Mechanotherapy" means all of the following:15897

       (i) Examining patients by verbal inquiry;15898

       (ii) Examination of the musculoskeletal system by hand;15899

       (iii) Visual inspection and observation;15900

       (iv) Diagnosing a patient's condition only as to whether the 15901
patient has a disorder of the musculoskeletal system;15902

       (v) In the treatment of patients, employing the techniques of 15903
advised or supervised exercise; electrical neuromuscular15904
stimulation; massage or manipulation; or air, water, heat, cold,15905
sound, or infrared ray therapy only to those disorders of the15906
musculoskeletal system that are amenable to treatment by such15907
techniques and that are identifiable by examination performed in15908
accordance with division (B)(1)(a)(i) of this section and15909
diagnosable in accordance with division (B)(1)(a)(ii) of this15910
section.15911

       (b) "Educational requirements" means the completion of a15912
course of study appropriate for certification to practice15913
mechanotherapy on or before November 3, 1985, as determined by15914
rules adopted under this chapter.15915

       (2) Mechanotherapists who received a certificate to practice 15916
from the board prior to March 2, 1992, may continue to practice15917
mechanotherapy, as defined in rules adopted by the board. Such15918
mechanotherapists shall practice in accordance with rules adopted15919
by the board.15920

       A person authorized by this division to practice as a15921
mechanotherapist may examine, diagnose, and assume responsibility15922
for the care of patients with due regard for first aid and the15923
hygienic and nutritional care of the patients. Roentgen rays shall 15924
be used by a mechanotherapist only for diagnostic purposes.15925

       (3) A person who holds a certificate to practice15926
mechanotherapy and completed educational requirements in15927
mechanotherapy on or before November 3, 1985, is entitled to use15928
the title "doctor of mechanotherapy" and is a "physician" who15929
performs "medical services" for the purposes of Chapters 4121. and 15930
4123. of the Revised Code and the medicaid program established 15931
under section 5111.01 of the Revised Code, and shall receive 15932
payment or reimbursement as provided under those chapters and that 15933
sectionprogram.15934

       Sec. 4731.65.  As used in sections 4731.65 to 4731.71 of the 15935
Revised Code:15936

       (A)(1) "Clinical laboratory services" means either of the 15937
following:15938

       (a) Any examination of materials derived from the human body 15939
for the purpose of providing information for the diagnosis,15940
prevention, or treatment of any disease or impairment or for the15941
assessment of health;15942

       (b) Procedures to determine, measure, or otherwise describe 15943
the presence or absence of various substances or organisms in the 15944
body.15945

       (2) "Clinical laboratory services" does not include the mere 15946
collection or preparation of specimens.15947

       (B) "Designated health services" means any of the following:15948

       (1) Clinical laboratory services;15949

       (2) Home health care services;15950

       (3) Outpatient prescription drugs.15951

       (C) "Fair market value" means the value in arms-length15952
transactions, consistent with general market value and:15953

       (1) With respect to rentals or leases, the value of rental15954
property for general commercial purposes, not taking into account15955
its intended use;15956

       (2) With respect to a lease of space, not adjusted to reflect 15957
the additional value the prospective lessee or lessor would 15958
attribute to the proximity or convenience to the lessor if the 15959
lessor is a potential source of referrals to the lessee.15960

       (D) "Governmental health care program" means any program15961
providing health care benefits that is administered by the federal 15962
government, this state, or a political subdivision of this state, 15963
including the medicare program established under Title XVIII of 15964
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 15965
as amended, health care coverage for public employees, health care 15966
benefits administered by the bureau of workers' compensation, the 15967
medicaid program established under Chapter 5111. of the Revised 15968
Code, the disability medical assistance program established15969
under Chapter 5115. of the Revised Code, and the children's 15970
buy-in program established under sections 5101.5211 to 5101.5216 15971
of the Revised Code.15972

       (E)(1) "Group practice" means a group of two or more holders 15973
of certificates under this chapter legally organized as a15974
partnership, professional corporation or association, limited 15975
liability company, foundation, nonprofit corporation, faculty 15976
practice plan, or similar group practice entity, including an 15977
organization comprised of a nonprofit medical clinic that 15978
contracts with a professional corporation or association of 15979
physicians to provide medical services exclusively to patients of 15980
the clinic in order to comply with section 1701.03 of the Revised 15981
Code and including a corporation, limited liability company,15982
partnership, or professional association described in division (B) 15983
of section 4731.226 of the Revised Code formed for the purpose of 15984
providing a combination of the professional services of15985
optometrists who are licensed, certificated, or otherwise legally 15986
authorized to practice optometry under Chapter 4725. of the 15987
Revised Code, chiropractors who are licensed, certificated, or 15988
otherwise legally authorized to practice chiropractic or 15989
acupuncture under Chapter 4734. of the Revised Code, psychologists 15990
who are licensed, certificated, or otherwise legally authorized to 15991
practice psychology under Chapter 4732. of the Revised Code, 15992
registered or licensed practical nurses who are licensed, 15993
certificated, or otherwise legally authorized to practice nursing 15994
under Chapter 4723. of the Revised Code, pharmacists who are 15995
licensed, certificated, or otherwise legally authorized to 15996
practice pharmacy under Chapter 4729. of the Revised Code, 15997
physical therapists who are licensed, certificated, or otherwise 15998
legally authorized to practice physical therapy under sections 15999
4755.40 to 4755.56 of the Revised Code, occupational therapists 16000
who are licensed, certificated, or otherwise legally authorized to 16001
practice occupational therapy under sections 4755.04 to 4755.13 of 16002
the Revised Code, mechanotherapists who are licensed, 16003
certificated, or otherwise legally authorized to practice 16004
mechanotherapy under section 4731.151 of the Revised Code, and 16005
doctors of medicine and surgery, osteopathic medicine and surgery, 16006
or podiatric medicine and surgery who are licensed, certificated, 16007
or otherwise legally authorized for their respective practices 16008
under this chapter, to which all of the following apply:16009

       (a) Each physician who is a member of the group practice16010
provides substantially the full range of services that the16011
physician routinely provides, including medical care,16012
consultation, diagnosis, or treatment, through the joint use of16013
shared office space, facilities, equipment, and personnel.16014

       (b) Substantially all of the services of the members of the 16015
group are provided through the group and are billed in the name of 16016
the group and amounts so received are treated as receipts of the 16017
group.16018

       (c) The overhead expenses of and the income from the practice 16019
are distributed in accordance with methods previously determined 16020
by members of the group.16021

       (d) The group practice meets any other requirements that the 16022
state medical board applies in rules adopted under section 4731.70 16023
of the Revised Code.16024

       (2) In the case of a faculty practice plan associated with a 16025
hospital with a medical residency training program in which16026
physician members may provide a variety of specialty services and16027
provide professional services both within and outside the group,16028
as well as perform other tasks such as research, the criteria in16029
division (E)(1) of this section apply only with respect to16030
services rendered within the faculty practice plan.16031

       (F) "Home health care services" and "immediate family" have 16032
the same meanings as in the rules adopted under section 4731.70 of 16033
the Revised Code.16034

       (G) "Hospital" has the same meaning as in section 3727.01 of 16035
the Revised Code.16036

       (H) A "referral" includes both of the following:16037

       (1) A request by a holder of a certificate under this chapter 16038
for an item or service, including a request for a consultation 16039
with another physician and any test or procedure ordered by or to 16040
be performed by or under the supervision of the other physician;16041

       (2) A request for or establishment of a plan of care by a16042
certificate holder that includes the provision of designated 16043
health services.16044

       (I) "Third-party payer" has the same meaning as in section 16045
3901.38 of the Revised Code.16046

       Sec. 4731.71.  The auditor of state may implement procedures16047
to detect violations of section 4731.66 or 4731.69 of the Revised16048
Code within governmental health care programs administered by the16049
state. The auditor of state shall report any violation of either16050
section to the state medical board and shall certify to the16051
attorney general in accordance with section 131.02 of the Revised16052
Code the amount of any refund owed to a state-administered16053
governmental health care program under section 4731.69 of the16054
Revised Code as a result of a violation. If a refund is owed to16055
the medicaid program established under Chapter 5111. of the 16056
Revised Code, the disability medical assistance program 16057
established under Chapter 5115. of the Revised Code, or the 16058
children's buy-in program established under sections 5101.5211 to 16059
5101.5216 of the Revised Code, the auditor of state also shall16060
report the amount to the department of job and family services16061
health care administration.16062

       The state medical board also may implement procedures to16063
detect violations of section 4731.66 or 4731.69 of the Revised16064
Code.16065

       Sec. 4752.02. (A) Except as provided in division (B) of this 16066
section, no person shall provide home medical equipment services 16067
or claim to the public to be a home medical equipment services 16068
provider unless either of the following is the case:16069

       (1) The person holds a valid license issued under this 16070
chapter;16071

       (2) The person holds a valid certificate of registration 16072
issued under this chapter.16073

       (B) Division (A) of this section does not apply to any of the 16074
following:16075

       (1) A health care practitioner, as defined in section 4769.01 16076
of the Revised Code, who does not sell or rent home medical 16077
equipment;16078

       (2) A hospital that provides home medical equipment services16079
only as an integral part of patient care and does not provide the16080
services through a separate entity that has its own medicare or16081
medicaid provider number;16082

       (3) A manufacturer or wholesale distributor of home medical16083
equipment that does not sell directly to the public;16084

       (4) A hospice care program, as defined by section 3712.01 of16085
the Revised Code, that does not sell or rent home medical16086
equipment;16087

       (5) A home, as defined by section 3721.01 of the Revised16088
Code;16089

       (6) A home health agency that is certified under Title XVIII16090
of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1395,16091
medicare program as a provider of home health services and does16092
not sell or rent home medical equipment;16093

       (7) An individual who holds a current, valid license issued16094
under Chapter 4741. of the Revised Code to practice veterinary16095
medicine;16096

        (8) An individual who holds a current, valid license issued16097
under Chapter 4779. of the Revised Code to practice orthotics,16098
prosthetics, or pedorthics;16099

        (9) A pharmacy licensed under Chapter 4729. of the Revised16100
Code that either does not sell or rent home medical equipment or16101
receives total payments of less than ten thousand dollars per year16102
from selling or renting home medical equipment;16103

        (10) A home dialysis equipment provider regulated by federal16104
law.16105

       Sec. 4752.09. (A) The Ohio respiratory care board may, in16106
accordance with Chapter 119. of the Revised Code, suspend or16107
revoke a license issued under this chapter or discipline a license16108
holder by imposing a fine of not more than five thousand dollars16109
or taking other disciplinary action on any of the following16110
grounds:16111

       (1) Violation of any provision of this chapter or an order or16112
rule of the board, as those provisions, orders, or rules are 16113
applicable to persons licensed under this chapter;16114

       (2) A plea of guilty to or a judicial finding of guilt of a16115
felony or a misdemeanor that involves dishonesty or is directly16116
related to the provision of home medical equipment services;16117

       (3) Making a material misstatement in furnishing information16118
to the board;16119

       (4) Professional incompetence;16120

       (5) Being guilty of negligence or gross misconduct in16121
providing home medical equipment services;16122

       (6) Aiding, assisting, or willfully permitting another person 16123
to violate any provision of this chapter or an order or rule of16124
the board, as those provisions, orders, or rules are applicable to 16125
persons licensed under this chapter;16126

       (7) Failing, within sixty days, to provide information in16127
response to a written request by the board;16128

       (8) Engaging in conduct likely to deceive, defraud, or harm16129
the public;16130

       (9) Denial, revocation, suspension, or restriction of a16131
license to provide home medical equipment services, for any reason16132
other than failure to renew, in another state or jurisdiction;16133

       (10) Directly or indirectly giving to or receiving from any16134
person a fee, commission, rebate, or other form of compensation16135
for services not rendered;16136

       (11) Knowingly making or filing false records, reports, or16137
billings in the course of providing home medical equipment 16138
services, including false records, reports, or billings prepared16139
for or submitted to state and federal agencies or departments;16140

       (12) Failing to comply with federal rules issued pursuant to16141
the medicare program established under Title XVIII of the "Social16142
Security Act," 49 Stat. 620(1935), 42 U.S.C. 1395, as amended,16143
relating to operations, financial transactions, and general16144
business practices of home medical services providers.16145

       (B) The respiratory care board immediately may suspend a 16146
license without a hearing if it determines that there is evidence 16147
that the license holder is subject to actions under this section 16148
and that there is clear and convincing evidence that continued16149
operation by the license holder presents an immediate and serious 16150
harm to the public. The president and executive director of the 16151
board shall make a preliminary determination and describe, by 16152
telephone conference or any other method of communication, the 16153
evidence on which they made their determination to the other 16154
members of the board. The board may by resolution designate 16155
another board member to act in place of the president of the board 16156
or another employee to act in the place of the executive director, 16157
in the event that the board president or executive director is 16158
unavailable or unable to act. On review of the evidence, the board 16159
may by a vote of not less than seven of its members, suspend a 16160
license without a prior hearing. The board may vote on the 16161
suspension by way of a telephone conference call.16162

       Immediately following the decision to suspend a license under16163
this division, the board shall issue a written order of suspension16164
and cause it to be delivered in accordance with section 119.07 of16165
the Revised Code. The order shall not be subject to suspension by16166
the court during the pendency of any appeal filed under section16167
119.12 of the Revised Code. If the license holder requests an16168
adjudication hearing, the date set for the hearing shall be within16169
fifteen days but not earlier than seven days after the license16170
holder requests the hearing, unless another date is agreed to by16171
the license holder and the board. The suspension shall remain in16172
effect, unless reversed by the board, until a final adjudication16173
order issued by the board pursuant to this section and Chapter16174
119. of the Revised Code becomes effective. The board shall issue16175
its final adjudication order not later than ninety days after16176
completion of the hearing. The board's failure to issue the order16177
by that day shall cause the summary suspension to end, but shall16178
not affect the validity of any subsequent final adjudication16179
order.16180

       Sec. 4753.071.  A person who is required to meet the 16181
supervised professional experience requirement of division (F) of 16182
section 4753.06 of the Revised Code shall submit to the board of 16183
speech-language pathology and audiology an application for a 16184
conditional license. The application shall include a plan for the 16185
content of the supervised professional experience on a form the 16186
board shall prescribe. The board shall issue the conditional 16187
license to the applicant if the applicant meets the requirements 16188
of section 4753.06 of the Revised Code, other than the requirement 16189
to have obtained the supervised professional experience, and pays 16190
to the board the appropriate fee for a conditional license. An 16191
applicant may not begin employment until the conditional license 16192
has been issued.16193

       A conditional license authorizes an individual to practice16194
speech-language pathology or audiology while completing the16195
supervised professional experience as required by division (F) of16196
section 4753.06 of the Revised Code. A person holding a16197
conditional license may practice speech-language pathology or16198
audiology while working under the supervision of a person fully16199
licensed in accordance with this chapter. A conditional license is 16200
valid for eighteen months unless suspended or revoked pursuant to 16201
section 3123.47 or 4753.10 of the Revised Code.16202

       A person holding a conditional license may perform services16203
for which reimbursement will be sought under the medicare program16204
established under Title XVIII of the "Social Security Act," 79 16205
Stat. 286 (1965), 42 U.S.C. 1395, as amended, or the medicaid 16206
program established under Chapter 5111. of the Revised Code but 16207
all requests for reimbursement for such services shall be made by 16208
the person who supervises the person performing the services.16209

       Sec. 4755.481. (A) If a physical therapist evaluates and 16210
treats a patient without the prescription of, or the referral of 16211
the patient by, a person who is licensed to practice medicine and 16212
surgery, chiropractic, dentistry, osteopathic medicine and 16213
surgery, podiatric medicine and surgery, or nursing as a certified 16214
registered nurse anesthetist, clinical nurse specialist, certified 16215
nurse-midwife, or certified nurse practitioner, all of the 16216
following apply:16217

       (1) The physical therapist shall, upon consent of the 16218
patient, inform the patient's physician, chiropractor, dentist, 16219
podiatrist, certified registered nurse anesthetist, clinical nurse 16220
specialist, certified nurse-midwife, or certified nurse 16221
practitioner of the evaluation not later than five business days 16222
after the evaluation is made.16223

        (2) If the physical therapist determines, based on reasonable 16224
evidence, that no substantial progress has been made with respect 16225
to that patient during the thirty-day period immediately following 16226
the date of the patient's initial visit with the physical 16227
therapist, the physical therapist shall consult with or refer the 16228
patient to a licensed physician, chiropractor, dentist, 16229
podiatrist, certified registered nurse anesthetist, clinical nurse 16230
specialist, certified nurse-midwife, or certified nurse 16231
practitioner, unless either of the following applies:16232

        (a) The evaluation, treatment, or services are being provided 16233
for fitness, wellness, or prevention purposes.16234

        (b) The patient previously was diagnosed with chronic, 16235
neuromuscular, or developmental conditions and the evaluation, 16236
treatment, or services are being provided for problems or symptoms 16237
associated with one or more of those previously diagnosed 16238
conditions.16239

        (3) If the physical therapist determines that orthotic 16240
devices are necessary to treat the patient, the physical therapist 16241
shall be limited to the application of the following orthotic 16242
devices:16243

        (a) Upper extremity adaptive equipment used to facilitate the 16244
activities of daily living;16245

        (b) Finger splints;16246

        (c) Wrist splints;16247

        (d) Prefabricated elastic or fabric abdominal supports with 16248
or without metal or plastic reinforcing stays and other 16249
prefabricated soft goods requiring minimal fitting;16250

        (e) Nontherapeutic accommodative inlays;16251

        (f) Shoes that are not manufactured or modified for a 16252
particular individual;16253

        (g) Prefabricated foot care products;16254

       (h) Custom foot orthotics;16255

        (i) Durable medical equipment.16256

        (4) If, at any time, the physical therapist has reason to 16257
believe that the patient has symptoms or conditions that require 16258
treatment or services beyond the scope of practice of a physical 16259
therapist, the physical therapist shall refer the patient to a 16260
licensed health care practitioner acting within the practitioner's 16261
scope of practice.16262

        (B) Nothing in sections 4755.40 to 4755.56 of the Revised 16263
Code shall be construed to require reimbursement under any health 16264
insuring corporation policy, contract, or agreement, any sickness 16265
and accident insurance policy, the medical assistancemedicaid16266
program as defined in section 5111.01 of the Revised Code, or the 16267
health partnership program or qualified health plans established 16268
pursuant to sections 4121.44 to 4121.442 of the Revised Code, for 16269
any physical therapy service rendered without the prescription of, 16270
or the referral of the patient by, a licensed physician, 16271
chiropractor, dentist, podiatrist, certified registered nurse 16272
anesthetist, clinical nurse specialist, certified nurse-midwife, 16273
or certified nurse practitioner.16274

       (C) For purposes of this section, "business day" means any 16275
calendar day that is not a Saturday, Sunday, or legal holiday. 16276
"Legal holiday" has the same meaning as in section 1.14 of the 16277
Revised Code.16278

       Sec. 4758.02. (A) Effective two years after the date the16279
department of alcohol and drug addiction services ceases to16280
administer its certification and credentialing process under16281
section 3793.07 of the Revised Code as specified in division 16282
(B)(A) of that section and except as provided in sections 4758.03 16283
and 4758.04 of the Revised Code, no person shall do any of the16284
following:16285

       (1) Engage in or represent to the public that the person16286
engages in chemical dependency counseling for a fee, salary, or16287
other consideration unless the person holds a valid independent16288
chemical dependency counselor license, chemical dependency16289
counselor III license, chemical dependency counselor II license,16290
chemical dependency counselor I certificate, or chemical16291
dependency counselor assistant certificate issued under this16292
chapter;16293

       (2) Use the title "licensed independent chemical dependency16294
counselor," "LICDC," "licensed chemical dependency counselor III,"16295
"LCDC III," "licensed chemical dependency counselor II," "LCDC16296
II," "certified chemical dependency counselor I," "CCDC I,"16297
"chemical dependency counselor assistant," "CDCA," or any other16298
title or description incorporating the word "chemical dependency16299
counselor" or any other initials used to identify persons acting16300
in those capacities unless currently authorized under this chapter16301
to act in the capacity indicated by the title or initials;16302

       (3) Represent to the public that the person is a registered16303
applicant unless the person holds a valid registered applicant16304
certificate issued under this chapter;16305

       (4) Use the title "certified prevention specialist II," "CPS 16306
II," "certified prevention specialist I," "CPS I," "registered 16307
applicant," or any other title, description, or initials used to 16308
identify persons acting in those capacities unless currently 16309
authorized under this chapter to act in the capacity indicated by 16310
the title or initials.16311

       (B) Effective six years after the effective date of this16312
sectionDecember 23, 2002, no person shall engage in or represent 16313
to the public that the person engages in chemical dependency 16314
counseling as a chemical dependency counselor I.16315

       Sec. 4758.04. After the date the department of alcohol and16316
drug addiction services ceases to administer its certification and16317
credentialing process under section 3793.07 of the Revised Code as16318
specified in division (B)(A) of that section, an individual who16319
holds, on the effective date of this sectionDecember 23, 2002, a 16320
valid certificate or credentials that are accepted under section 16321
3793.07 of the Revised Code as authority to practice as a chemical 16322
dependency counselor or alcohol and other drug prevention 16323
specialist may apply to the chemical dependency professionals 16324
board for the board to delay the expiration date of the 16325
individual's certificate or credentials. If the board determines 16326
that there is good cause for delaying the expiration date, the 16327
board may delay the expiration date until a date the board 16328
specifies. The date the board specifies shall not be later than 16329
the date that is three years after the effective date of the 16330
board's initial rules adopted under section 4758.20 of the Revised 16331
Code.16332

       An individual who has the expiration date of the individual's 16333
certificate or credentials delayed under this section may perform 16334
services within the scope, standards, and ethics of the 16335
certificate or credentials until the date of the delayed16336
expiration date.16337

       Sec. 4761.01.  As used in this chapter:16338

       (A) "Respiratory care" means rendering or offering to render 16339
to individuals, groups, organizations, or the public any service 16340
involving the evaluation of cardiopulmonary function, the16341
treatment of cardiopulmonary impairment, the assessment of16342
treatment effectiveness, and the care of patients with16343
deficiencies and abnormalities associated with the cardiopulmonary 16344
system. The practice of respiratory care includes:16345

       (1) Obtaining, analyzing, testing, measuring, and monitoring 16346
blood and gas samples in the determination of cardiopulmonary 16347
parameters and related physiologic data, including flows, 16348
pressures, and volumes, and the use of equipment employed for this 16349
purpose;16350

       (2) Administering, monitoring, recording the results of, and 16351
instructing in the use of medical gases, aerosols, and16352
bronchopulmonary hygiene techniques, including drainage,16353
aspiration, and sampling, and applying, maintaining, and16354
instructing in the use of artificial airways, ventilators, and16355
other life support equipment employed in the treatment of16356
cardiopulmonary impairment and provided in collaboration with16357
other licensed health care professionals responsible for providing 16358
care;16359

       (3) Performing cardiopulmonary resuscitation and respiratory 16360
rehabilitation techniques;16361

       (4) Administering medications for the testing or treatment of 16362
cardiopulmonary impairment.16363

       (B) "Respiratory care professional" means a person who is16364
licensed under this chapter to practice the full range of16365
respiratory care services as defined in division (A) of this16366
section.16367

       (C) "Physician" means an individual authorized under Chapter16368
4731. of the Revised Code to practice medicine and surgery or16369
osteopathic medicine and surgery.16370

       (D) "Registered nurse" means an individual licensed under16371
Chapter 4723. of the Revised Code to engage in the practice of 16372
nursing as a registered nurse.16373

       (E) "Hospital" means a facility that meets the operating16374
standards of section 3727.02 of the Revised Code.16375

       (F) "Nursing facility" has the same meaning as in section 16376
5111.205164.01 of the Revised Code.16377

       Sec. 4761.03.  The Ohio respiratory care board shall regulate16378
the practice of respiratory care in this state and the persons to16379
whom the board issues licenses and limited permits under this 16380
chapter and shall license and register home medical equipment 16381
services providers under Chapter 4752. of the Revised Code. Rules 16382
adopted under this chapter that deal with the provision of16383
respiratory care in a hospital, other than rules regulating the16384
issuance of licenses or limited permits, shall be consistent with 16385
the conditions for participation under medicare, Title XVIII of 16386
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395, 16387
as amended, and with the respiratory care accreditation standards 16388
of the joint commission on accreditation of healthcare16389
organizations or the American osteopathic association.16390

       The board shall:16391

       (A) Adopt, and may rescind or amend, rules in accordance with 16392
Chapter 119. of the Revised Code to carry out the purposes of this 16393
chapter, including rules prescribing:16394

       (1) The form and manner for filing applications for licensure 16395
and renewal, limited permits, and limited permit extensions under 16396
sections 4761.05 and 4761.06 of the Revised Code;16397

       (2) The form, scoring, and scheduling of examinations and16398
reexaminations for licensure and license renewal;16399

       (3) Standards for the approval of educational programs16400
required to qualify for licensure and continuing education16401
programs required for license renewal;16402

       (4) Continuing education courses and the number of hour16403
requirements necessary for license renewal, in accordance with16404
section 4761.06 of the Revised Code;16405

       (5) Procedures for the issuance and renewal of licenses and16406
limited permits, including the duties that may be fulfilled by the 16407
board's executive director and other board employees;16408

       (6) Procedures for the denial, suspension, permanent16409
revocation, refusal to renew, and reinstatement of licenses and16410
limited permits, the conduct of hearings, and the imposition of16411
fines for engaging in conduct that is grounds for such action and16412
hearings under section 4761.09 of the Revised Code;16413

       (7) Standards of ethical conduct for the practice of16414
respiratory care;16415

       (8) Conditions under which the license renewal fee and16416
continuing education requirements may be waived at the request of16417
a licensee who is not in active practice;16418

       (9) The respiratory care tasks that may be performed by an16419
individual practicing as a polysomnographic technologist pursuant16420
to division (B)(3) of section 4761.10 of the Revised Code;16421

       (10) Procedures for registering out-of-state respiratory care16422
providers authorized to practice in this state under division16423
(A)(4) of section 4761.11 of the Revised Code;16424

       (11) Requirements for criminal records checks of applicants 16425
under section 4776.03 of the Revised Code.16426

       (B) Determine the sufficiency of an applicant's16427
qualifications for admission to the licensing examination or a16428
reexamination, and for the issuance or renewal of a license or16429
limited permit;16430

       (C) Determine the respiratory care educational programs that16431
are acceptable for fulfilling the requirements of division (A) of16432
section 4761.04 of the Revised Code;16433

       (D) Schedule, administer, and score the licensing examination 16434
or any reexamination for license renewal or reinstatement. The 16435
board shall administer the licensing examinations at least twice a 16436
year and notify applicants of the time and place of the 16437
examinations.16438

       (E) Investigate complaints concerning alleged violations of16439
section 4761.10 of the Revised Code or grounds for the suspension,16440
permanent revocation, or refusal to issue licenses or limited16441
permits under section 3123.47 or 4761.09 of the Revised Code. The16442
board shall employ investigators who shall, under the direction of16443
the executive director of the board, investigate complaints and16444
make inspections and other inquiries as, in the judgment of the16445
board, are appropriate to enforce sections 3123.41 to 3123.50,16446
4761.09, and 4761.10 of the Revised Code. Pursuant to an16447
investigation and inspection, the investigators may review and16448
audit records during normal business hours at the place of16449
business of a licensee or person who is the subject of a complaint16450
filed with the board or at any place where the records are kept.16451

       Except when required by court order, the board and its16452
employees shall not disclose confidential information obtained16453
during an investigation or identifying information about any16454
person who files a complaint with the board.16455

       The board may hear testimony in matters relating to the16456
duties imposed upon it and issue subpoenas pursuant to an16457
investigation. The president and secretary of the board may16458
administer oaths.16459

       (F) Conduct hearings, keep records of its proceedings, and do 16460
other things as are necessary and proper to carry out and enforce 16461
the provisions of this chapter;16462

       (G) Maintain, publish, and make available upon request, for a 16463
fee not to exceed the actual cost of printing and mailing:16464

       (1) The requirements for the issuance of licenses and limited 16465
permits under this chapter and rules adopted by the board;16466

       (2) A current register of every person licensed to practice16467
respiratory care in this state, to include the addresses of the16468
person's last known place of business and residence, the effective16469
date and identification number of the license, the name and16470
location of the institution that granted the person's degree or16471
certificate of completion of respiratory care educational16472
requirements, and the date the degree or certificate was issued;16473

       (3) A list of the names and locations of the institutions16474
that each year granted degrees or certificates of completion in16475
respiratory care;16476

       (4) After the administration of each examination, a list of16477
persons who passed the examination.16478

       (H) Submit to the governor and to the general assembly each16479
year a report of all of its official actions during the preceding16480
year, together with any findings and recommendations with regard16481
to the improvement of the profession of respiratory care;16482

       (I) Administer and enforce Chapter 4752. of the Revised Code.16483

       Sec. 4769.01.  As used in this chapter:16484

       (A) "Medicare" means the program established by Title XVIII 16485
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 16486
301, as amended.16487

       (B) "Balance billing" means charging or collecting from a 16488
medicare beneficiary an amount in excess of the medicare 16489
reimbursement rate for medicare-covered services or supplies 16490
provided to a medicare beneficiary, except when medicare is the 16491
secondary insurer. When medicare is the secondary insurer, the 16492
health care practitioner may pursue full reimbursement under the 16493
terms and conditions of the primary coverage and, if applicable, 16494
the charge allowed under the terms and conditions of the 16495
appropriate provider contract, from the primary insurer, but the 16496
medicare beneficiary cannot be balance billed above the medicare 16497
reimbursement rate for a medicare-covered service or supply. 16498
"Balance billing" does not include charging or collecting 16499
deductibles or coinsurance required by the program.16500

       (C)(B) "Health care practitioner" means all of the following:16501

       (1) A dentist or dental hygienist licensed under Chapter16502
4715. of the Revised Code;16503

       (2) A registered or licensed practical nurse licensed under 16504
Chapter 4723. of the Revised Code;16505

       (3) An optometrist licensed under Chapter 4725. of the16506
Revised Code;16507

       (4) A dispensing optician, spectacle dispensing optician,16508
contact lens dispensing optician, or spectacle-contact lens16509
dispensing optician licensed under Chapter 4725. of the Revised16510
Code;16511

       (5) A pharmacist licensed under Chapter 4729. of the Revised 16512
Code;16513

       (6) A physician authorized under Chapter 4731. of the Revised 16514
Code to practice medicine and surgery, osteopathic medicine and 16515
surgery, or podiatry;16516

       (7) A physician assistant authorized under Chapter 4730. of16517
the Revised Code to practice as a physician assistant;16518

       (8) A practitioner of a limited branch of medicine issued a 16519
certificate under Chapter 4731. of the Revised Code;16520

       (9) A psychologist licensed under Chapter 4732. of the16521
Revised Code;16522

       (10) A chiropractor licensed under Chapter 4734. of the16523
Revised Code;16524

       (11) A hearing aid dealer or fitter licensed under Chapter16525
4747. of the Revised Code;16526

       (12) A speech-language pathologist or audiologist licensed 16527
under Chapter 4753. of the Revised Code;16528

       (13) An occupational therapist or occupational therapy16529
assistant licensed under Chapter 4755. of the Revised Code;16530

       (14) A physical therapist or physical therapy assistant16531
licensed under Chapter 4755. of the Revised Code;16532

       (15) A professional clinical counselor, professional 16533
counselor, social worker, or independent social worker licensed, 16534
or a social work assistant registered, under Chapter 4757. of the16535
Revised Code;16536

       (16) A dietitian licensed under Chapter 4759. of the Revised 16537
Code;16538

       (17) A respiratory care professional licensed under Chapter 16539
4761. of the Revised Code;16540

       (18) An emergency medical technician-basic, emergency medical16541
technician-intermediate, or emergency medical technician-paramedic 16542
certified under Chapter 4765. of the Revised Code.16543

       Sec. 5101.07.  There is hereby created in the state treasury 16544
the ODJFS support services federal operating fund. The fund shall 16545
consist of federal funds the department of job and family services 16546
receives and that the director of job and family services 16547
determines are appropriate for deposit into the fund. Money in the 16548
fund shall be used to pay the federal share of both of the 16549
following:16550

        (A) The department's costs for computer projects;16551

        (B) The operating costs of the parts of the department that 16552
provide general support services for the department's work units 16553
established under section 5101.06 of the Revised Code.16554

       Sec. 5101.071.  There is hereby created in the state treasury 16555
the ODJFS support services state operating fund. The fund shall 16556
consist of payments made to the fund from other appropriation 16557
items by intrastate transfer voucher. Money in the fund shall be 16558
used to pay for both of the following:16559

        (A) The department of job and family services' costs for 16560
computer projects;16561

        (B) The operating costs of the parts of the department that 16562
provide general support services for the department's work units 16563
established under section 5101.06 of the Revised Code.16564

       Sec. 5101.11. This section does not apply to contracts16565
entered into under section 5111.90 or 5111.91 of the Revised Code.16566

       (A) As used in this section:16567

       (1) "Entity" includes an agency, board, commission, or16568
department of the state or a political subdivision of the state; a16569
private, nonprofit entity; a school district; a private school; or16570
a public or private institution of higher education.16571

       (2) "Federal financial participation" means the federal16572
government's share of expenditures made by an entity in16573
implementing a program administered by the department of job and16574
family services.16575

       (B) At the request of any public entity having authority to16576
implement a program administered by the department of job and16577
family services or any private entity under contract with a public16578
entity to implement a program administered by the department, the16579
department may seek to obtain federal financial participation for16580
costs incurred by the entity. Federal financial participation may16581
be sought from programs operated pursuant to Title IV-A,and Title16582
IV-E, and Title XIX of the "Social Security Act," 49 Stat. 62016583
(1935), 42 U.S.C. 301, as amended; the "Food Stamp Act of 1964,"16584
78 Stat. 703, 7 U.S.C. 2011, as amended; and any other statute or16585
regulation under which federal financial participation may be16586
available, except that federal financial participation may be16587
sought only for expenditures made with funds for which federal16588
financial participation is available under federal law.16589

       (C) All funds collected by the department of job and family16590
services pursuant to division (B) of this section shall be16591
distributed to the entities that incurred the costs, except for16592
any amounts retained by the department pursuant to division (D)(3)16593
of this section.16594

       (D) In distributing federal financial participation pursuant16595
to this section, the department may either enter into an agreement16596
with the entity that is to receive the funds or distribute the16597
funds in accordance with rules adopted under division (F) of this16598
section. If the department decides to enter into an agreement to16599
distribute the funds, the agreement may include terms that do any16600
of the following:16601

       (1) Provide for the whole or partial reimbursement of any16602
cost incurred by the entity in implementing the program;16603

       (2) In the event that federal financial participation is16604
disallowed or otherwise unavailable for any expenditure, require16605
the department of job and family services or the entity, whichever16606
party caused the disallowance or unavailability of federal16607
financial participation, to assume responsibility for the16608
expenditures;16609

       (3) Permit the department to retain not more than five per16610
cent of the amount of the federal financial participation to be16611
distributed to the entity;16612

       (4) Require the public entity to certify the availability of16613
sufficient unencumbered funds to match the federal financial16614
participation it receives under this section;16615

       (5) Establish the length of the agreement, which may be for a 16616
fixed or a continuing period of time;16617

       (6) Establish any other requirements determined by the16618
department to be necessary for the efficient administration of the16619
agreement.16620

       (E) An entity that receives federal financial participation16621
pursuant to this section for a program aiding children and their16622
families shall establish a process for collaborative planning with16623
the department of job and family services for the use of the funds16624
to improve and expand the program.16625

       (F) The director of job and family services shall adopt rules 16626
as necessary to implement this section, including rules for the 16627
distribution of federal financial participation pursuant to this 16628
section. The rules shall be adopted in accordance with Chapter 16629
119. of the Revised Code. The director may adopt or amend any16630
statewide plan required by the federal government for a program16631
administered by the department, as necessary to implement this16632
section.16633

       (G) Federal financial participation received pursuant to this 16634
section shall not be included in any calculation made under16635
section 5101.16 or 5101.161 of the Revised Code.16636

       Sec. 5101.16.  (A) As used in this section and sections16637
5101.161 and 5101.162 of the Revised Code:16638

       (1) "Disability financial assistance" means the financial 16639
assistance program established under Chapter 5115. of the Revised 16640
Code.16641

       (2) "Disability medical assistance" means the medical 16642
assistance program established under Chapter 5115. of the Revised 16643
Code.16644

       (3) "Food stamps" means the program administered by the16645
department of job and family services pursuant to section 5101.5416646
of the Revised Code.16647

       (4) "Medicaid" means the medical assistance program16648
established by Chapter 5111. of the Revised Code, excluding16649
transportation services provided under that chapter.16650

       (5)(3) "Ohio works first" means the program established by16651
Chapter 5107. of the Revised Code.16652

       (6)(4) "Prevention, retention, and contingency" means the16653
program established by Chapter 5108. of the Revised Code.16654

       (7)(5) "Public assistance expenditures" means expenditures 16655
for all of the following:16656

       (a) Ohio works first;16657

       (b) County administration of Ohio works first;16658

       (c) Prevention, retention, and contingency;16659

       (d) County administration of prevention, retention, and16660
contingency;16661

       (e) Disability financial assistance;16662

       (f) Disability medical assistance;16663

       (g) County administration of disability financial assistance;16664

       (h) County administration of disability medical assistance;16665

       (i)(g) County administration of food stamps;16666

       (j) County administration of medicaid.16667

       (8)(6) "Public medical assistance expenditures" has the same 16668
meaning as in section 5160.26 of the Revised Code.16669

       (7) "Title IV-A program" has the same meaning as in section 16670
5101.80 of the Revised Code.16671

       (B) Each board of county commissioners shall pay the county16672
share of public assistance expenditures in accordance with section16673
5101.161 of the Revised Code. Except as provided in division (C)16674
of this section, a county's share of public assistance16675
expenditures is the sum of all of the following for state fiscal16676
year 1998 and each state fiscal year thereafter:16677

       (1) The amount that is twenty-five per cent of the county's16678
total expenditures for disability financial assistance and 16679
disability medical assistance and county administration of those 16680
programsdisability financial assistance during the state fiscal16681
year ending in the previous calendar year that the department of16682
job and family services determines are allowable.16683

       (2) The amount that is ten per cent, or other percentage16684
determined under division (D) of this section, of the county's16685
total expenditures for county administration of food stamps and16686
medicaid during the state fiscal year ending in the previous16687
calendar year that the department determines are allowable, less16688
the amount of federal reimbursement credited to the county under16689
division (E) of this section for the state fiscal year ending in16690
the previous calendar year;16691

       (3) A percentage of the actual amount of the county share of 16692
program and administrative expenditures during federal fiscal year 16693
1994 for assistance and services, other than child care, provided16694
under Titlesformer Title IV-A and IV-F of the "Social Security 16695
Act," 49 Stat. 620627 (1935), 42 U.S.C. 301601, and former Title 16696
IV-F of the "Social Security Act," 102 Stat. 2360 (1988), 42 16697
U.S.C. 681, as those titles existed prior to the enactment of the16698
"Personal Responsibility and Work Opportunity Reconciliation Act 16699
of 1996," 110 Stat. 2105. The department of job and family 16700
services shall determine the actual amount of the county share 16701
from expenditure reports submitted to the United States department 16702
of health and human services. The percentage shall be the 16703
percentage established in rules adopted under division (F) of this 16704
section.16705

       (C)(1) If a county's share of public assistance expenditures16706
determined under division (B) of this section and the county's 16707
share of public medical assistance expenditures determined under 16708
division (B) of section 5160.26 of the Revised Code for a state 16709
fiscal year exceeds one hundred ten per cent of the county's share 16710
for those expenditures for the immediately preceding state fiscal16711
year, the department of job and family services shall reduce the16712
county's share for expenditures under divisions (B)(1) and (2) of16713
this section so that the total of the county's share for public 16714
assistance expenditures under division (B) of this sectionand 16715
public medical assistance expenditures equals one hundred ten per 16716
cent of the county's share of those expenditures for the16717
immediately preceding state fiscal year. The department of job and 16718
family services shall cooperate with the department of health care 16719
administration for the purpose of making reductions under division 16720
(C)(1) of this section.16721

       (2) A county's share of public assistance expenditures16722
determined under division (B) of this section may be increased16723
pursuant to section 5101.163 of the Revised Code and a sanction 16724
under section 5101.24 of the Revised Code. An increase made 16725
pursuant to section 5101.163 of the Revised Code may cause the 16726
county's share to exceed the limit established by division (C)(1) 16727
of this section.16728

       (D)(1) If the per capita tax duplicate of a county is less16729
than the per capita tax duplicate of the state as a whole and16730
division (D)(2) of this section does not apply to the county, the16731
percentage to be used for the purpose of division (B)(2) of this16732
section is the product of ten multiplied by a fraction of which16733
the numerator is the per capita tax duplicate of the county and16734
the denominator is the per capita tax duplicate of the state as a16735
whole. The department of job and family services shall compute the 16736
per capita tax duplicate for the state and for each county by16737
dividing the tax duplicate for the most recent available year by16738
the current estimate of population prepared by the department of16739
development.16740

       (2) If the percentage of families in a county with an annual16741
income of less than three thousand dollars is greater than the16742
percentage of such families in the state and division (D)(1) of16743
this section does not apply to the county, the percentage to be16744
used for the purpose of division (B)(2) of this section is the16745
product of ten multiplied by a fraction of which the numerator is16746
the percentage of families in the state with an annual income of16747
less than three thousand dollars a year and the denominator is the16748
percentage of such families in the county. The department of job16749
and family services shall compute the percentage of families with16750
an annual income of less than three thousand dollars for the state16751
and for each county by multiplying the most recent estimate of16752
such families published by the department of development, by a16753
fraction, the numerator of which is the estimate of average annual16754
personal income published by the bureau of economic analysis of16755
the United States department of commerce for the year on which the16756
census estimate is based and the denominator of which is the most16757
recent such estimate published by the bureau.16758

       (3) If the per capita tax duplicate of a county is less than16759
the per capita tax duplicate of the state as a whole and the16760
percentage of families in the county with an annual income of less16761
than three thousand dollars is greater than the percentage of such16762
families in the state, the percentage to be used for the purpose16763
of division (B)(2) of this section shall be determined as follows:16764

       (a) Multiply ten by the fraction determined under division16765
(D)(1) of this section;16766

       (b) Multiply the product determined under division (D)(3)(a)16767
of this section by the fraction determined under division (D)(2)16768
of this section.16769

       (4) The department of job and family services shall16770
determine, for each county, the percentage to be used for the16771
purpose of division (B)(2) of this section not later than the16772
first day of July of the year preceding the state fiscal year for16773
which the percentage is used.16774

       (E) The department of job and family services shall credit to16775
a county the amount of federal reimbursement the department16776
receives from the United States departmentsdepartment of 16777
agriculture and health and human services for the county's 16778
expenditures for administration of food stamps and medicaid that 16779
the department determines are allowable administrative16780
expenditures.16781

       (F)(1) The director of job and family services shall adopt16782
rules in accordance with section 111.15 of the Revised Code to16783
establish all of the following:16784

       (a) The method the department is to use to change a county's16785
share of public assistance expenditures determined under division16786
(B) of this section as provided in division (C) of this section;16787

       (b) The allocation methodology and formula the department16788
will use to determine the amount of funds to credit to a county16789
under this section;16790

       (c) The method the department will use to change the payment16791
of the county share of public assistance expenditures from a16792
calendar-year basis to a state fiscal year basis;16793

       (d) The percentage to be used for the purpose of division 16794
(B)(3) of this section, which shall, except as provided in section 16795
5101.163 of the Revised Code, meet both of the following 16796
requirements:16797

       (i) The percentage shall not be less than seventy-five per 16798
cent nor more than eighty-two per cent;16799

       (ii) The percentage shall not exceed the percentage that the 16800
state's qualified state expenditures is of the state's historic 16801
state expenditures as those terms are defined in 42 U.S.C. 16802
609(a)(7).16803

       (e) Other procedures and requirements necessary to implement16804
this section.16805

       (2) The director of job and family services may amend the 16806
rule adopted under division (F)(1)(d) of this section to modify 16807
the percentage on determination that the amount the general 16808
assembly appropriates for Title IV-A programs makes the 16809
modification necessary. The rule shall be adopted and amended as 16810
if an internal management rule and in consultation with the 16811
director of budget and management.16812

       Sec. 5101.162.  Subject to available federal funds and 16813
appropriations made by the general assembly, the department of job 16814
and family services may, at its sole discretion, use available 16815
federal funds to reimburse county expenditures for county 16816
administration of food stamps or medicaid even though the county 16817
expenditures meet or exceed the maximum allowable reimbursement16818
amount established by rules adopted under section 5101.161 of the16819
Revised Code. The director may adopt internal management rules in 16820
accordance with section 111.15 of the Revised Code to implement 16821
this section.16822

       Sec. 5101.18. (A) When the director of job and family16823
services adopts rules under section 5107.05 regarding income16824
requirements for the Ohio works first program and under section 16825
5115.03 of the Revised Code regarding income and resource16826
requirements for the disability financial assistance program, the16827
director shall determine what payments shall be regarded or 16828
disregarded. In making this determination, the director shall 16829
consider:16830

       (1)(A) The source of the payment;16831

       (2)(B) The amount of the payment;16832

       (3)(C) The purpose for which the payment was made;16833

       (4)(D) Whether regarding the payment as income would be in16834
the public interest;16835

       (5)(E) Whether treating the payment as income would be16836
detrimental to any of the programs administered in whole or in16837
part by the department of job and family services or department of 16838
health care administration and whether such determination would16839
jeopardize the receipt of any federal grant or payment by the16840
state or any receipt of aid under Chapter 5107. of the Revised16841
Code.16842

       (B) Any recipient of aid under Title XVI of the "Social16843
Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended,16844
whose money payment is discontinued as the result of a general16845
increase in old-age, survivors, and disability insurance benefits16846
under such act, shall remain a recipient for the purpose of16847
receiving medical assistance through the medical assistance16848
program established under section 5111.01 of the Revised Code.16849

       Sec. 5101.181. (A) As used in this section and section 16850
5101.182 of the Revised Code, "public assistance" includes, in 16851
addition to Ohio works first, all of the following:16852

       (1) Prevention, retention, and contingency;16853

       (2) Medicaid;16854

       (3) Disability financial assistance;16855

       (4) Disability medical assistance;16856

       (5) General assistance provided prior to July 17, 1995, under 16857
former Chapter 5113. of the Revised Code.16858

       (B) As part of the procedure for the determination of 16859
overpayment to a recipient of public assistance under Chapter 16860
5107., 5108., 5111., or 5115. of the Revised Code, the director of 16861
job and family services shall furnish quarterly the name and 16862
social security number of each individual who receives public16863
assistance to the director of administrative services, the16864
administrator of the bureau of workers' compensation, and each of16865
the state's retirement boards. Within fourteen days after16866
receiving the name and social security number of an individual who 16867
receives public assistance, the director of administrative16868
services, administrator, or board shall inform the auditor of16869
state as to whether such individual is receiving wages or16870
benefits, the amount of any wages or benefits being received, the16871
social security number, and the address of the individual. The16872
director of administrative services, administrator, boards, and16873
any agent or employee of those officials and boards shall comply16874
with the rules of the director of job and family servicesadopted 16875
under section 5101.30 of the Revised Code restricting the 16876
disclosure of information regarding recipients of public16877
assistance. Any person who violates this provision shall16878
thereafter be disqualified from acting as an agent or employee or16879
in any other capacity under appointment or employment of any state 16880
board, commission, or agency.16881

       (C) The auditor of state may enter into a reciprocal16882
agreement with the director of job and family services or16883
comparable officer of any other state for the exchange of names, 16884
current or most recent addresses, or social security numbers of 16885
persons receiving public assistance under Title IV-A or under16886
Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 4216887
U.S.C. 301, as amended.16888

       (D)(1) The auditor of state shall retain, for not less than 16889
two years, at least one copy of all information received under 16890
this section and sections 145.27, 742.41, 3307.20, 3309.22, 16891
4123.27, 5101.182, and 5505.04 of the Revised Code. The auditor 16892
shall review the information to determine whether overpayments 16893
were made to recipients of public assistance under Chapters 5107., 16894
5108., 5111., and 5115. of the Revised Code. The auditor of state16895
shall initiate action leading to prosecution, where warranted, of16896
recipients who received overpayments by forwarding the name of16897
each recipient who received overpayment, together with other16898
pertinent information, to the director of job and family services 16899
and the attorney general, to the district director of job and16900
family services of the district through which public assistance 16901
was received, and to the county director of job and family 16902
services and county prosecutor of the county through which public 16903
assistance was received.16904

       (2) The auditor of state and the attorney general or their16905
designees may examine any records, whether in computer or printed16906
format, in the possession of the director of job and family 16907
services or any county director of job and family services. They16908
shall provide safeguards which restrict access to such records to 16909
purposes directly connected with an audit or investigation, 16910
prosecution, or criminal or civil proceeding conducted in 16911
connection with the administration of the programs and shall 16912
comply with the rules of the director of job and family services 16913
restricting the disclosure of information regarding recipients of 16914
public assistance. Any person who violates this provision shall 16915
thereafter be disqualified from acting as an agent or employee or 16916
in any other capacity under appointment or employment of any state 16917
board, commission, or agency.16918

       (3) Costs incurred by the auditor of state in carrying out16919
the auditor of state's duties under this division shall be borne 16920
by the auditor of state.16921

       Sec. 5101.182.  As part of the procedure for the16922
determination of overpayment to a recipient of public assistance16923
under Chapter 5107., 5111., or 5115. of the Revised Code, the16924
director of job and family services shall semiannually, at times16925
determined jointly by the auditor of state and the tax16926
commissioner, furnish to the tax commissioner in computer format16927
the name and social security number of each individual who16928
receives public assistance. Within sixty days after receiving the16929
name and social security number of a recipient of public16930
assistance, the commissioner shall inform the auditor of state16931
whether the individual filed an Ohio individual income tax return,16932
separate or joint, as provided by section 5747.08 of the Revised16933
Code, for either or both of the two taxable years preceding the16934
year in which the director furnished the names and social security16935
numbers to the commissioner. If the individual did so file, at the 16936
same time the commissioner shall also inform the auditor of state 16937
of the amount of the federal adjusted gross income as reported on 16938
such returns and of the addresses on such returns. The 16939
commissioner shall also advise the auditor of state whether such 16940
returns were filed on a joint basis, as provided in section16941
5747.08 of the Revised Code, in which case the federal adjusted16942
gross income as reported may be that of the individual or the16943
individual's spouse.16944

       If the auditor of state determines that further investigation16945
is needed, the auditor of state may request the commissioner to16946
determine whether the individual filed income tax returns for any16947
previous taxable years in which the individual received public16948
assistance and for which the tax department retains income tax16949
returns. Within fourteen days of receipt of the request, the16950
commissioner shall inform the auditor of state whether the16951
individual filed an individual income tax return for the taxable16952
years in question, of the amount of the federal adjusted gross16953
income as reported on such returns, of the addresses on such16954
returns, and whether the returns were filed on a joint or separate16955
basis.16956

       If the auditor of state determines that further investigation16957
is needed of a recipient of public assistance who filed an Ohio16958
individual income tax return, the auditor of state may request a16959
certified copy of the Ohio individual income tax return or returns16960
of that person for the taxable years described above, together16961
with any other documents the commissioner has concerning the16962
return or returns. Within fourteen days of receipt of such a16963
request in writing, the commissioner shall forward the returns and16964
documents to the auditor of state.16965

       The director of job and family services, district director of16966
job and family services, county director of job and family16967
services, county prosecutor, attorney general, auditor of state,16968
or any agent or employee of those officials having access to any16969
information or documents furnished by the commissioner pursuant to16970
this section shall not divulge or use any such information except16971
for the purpose of determining overpayment of public assistance,16972
or for an audit, investigation, or prosecution, or in accordance16973
with a proper judicial order. Any person who violates this16974
provision shall thereafter be disqualified from acting as an agent16975
or employee or in any other capacity under appointment or16976
employment of any state or county board, commission, or agency.16977

       Sec. 5101.184.  (A) The director of job and family services16978
shall work with the tax commissioner to collect overpayments of16979
assistance under Chapter 5107., 5111., or 5115., former Chapter16980
5113., or section 5101.54 of the Revised Code from refunds of16981
state income taxes for taxable year 1992 and thereafter that are16982
payable to the recipients of such overpayments.16983

       Any overpayment of assistance, whether obtained by fraud or16984
misrepresentation, as the result of an error by the recipient or16985
by the agency making the payment, or in any other manner, may be16986
collected under this section. Any reduction under section 5747.1216987
or 5747.121 of the Revised Code to an income tax refund shall be16988
made before a reduction under this section. No reduction shall be16989
made under this section if the amount of the refund is less than16990
twenty-five dollars after any reduction under section 5747.12 of16991
the Revised Code. A reduction under this section shall be made16992
before any part of the refund is contributed under section16993
5747.113 of the Revised Code, or is credited under section 5747.12 16994
of the Revised Code against tax due in any subsequent year.16995

       The director and the tax commissioner, by rules adopted in16996
accordance with Chapter 119. of the Revised Code, shall establish16997
procedures to implement this division. The procedures shall16998
provide for notice to a recipient of assistance and an opportunity16999
for the recipient to be heard before the recipient's income tax17000
refund is reduced.17001

       (B) The director of job and family services may enter into17002
agreements with the federal government to collect overpayments of17003
assistance from refunds of federal income taxes that are payable17004
to recipients of the overpayments.17005

       Sec. 5101.21.  (A) As used in sections 5101.21 to 5101.21217006
5101.25 of the Revised Code:17007

       (1) "County grantee" means all of the following:17008

        (a) A board of county commissioners;17009

       (b) A county children services board appointed under section 17010
5153.03 of the Revised Code;17011

        (c) A county elected official that is a child support 17012
enforcement agency.17013

       (2) "County subgrant" means a grant that a county grantee 17014
awards to another entity.17015

       (3) "County subgrant agreement" means an agreement between a 17016
county grantee and another entity under which the county grantee 17017
awards the other entity one or more county subgrants.17018

        (4) "Fiscal biennial period" means a two-year period 17019
beginning on the first day of July of an odd-numbered year and 17020
ending on the last day of June of the next odd-numbered year.17021

        (5) "Grant" means an award for one or more ODJFS family 17022
services duties of federal financial assistance that a federal 17023
agency provides in the form of money, or property in lieu of 17024
money, to the department of job and family services and that the 17025
department awards to a county grantee. "Grant" may include state 17026
funds the department awards to a county grantee to match the 17027
federal financial assistance. "Grant" does not mean either of the 17028
following:17029

        (a) Technical assistance that provides services instead of 17030
money;17031

        (b) Other assistance provided in the form of revenue sharing, 17032
loans, loan guarantees, interest subsidies, or insurance.17033

       (6) "Grant agreement" means an agreement between the 17034
department of job and family services and a county grantee under 17035
which the department awards the county grantee one or more grants.17036

       (7) "ODJFS family services duty" means a family services duty 17037
associated with a program that the department of job and family 17038
services supervises the administration of on the state level.17039

       (B) Effective July 1, 2008, the director of job and family 17040
services may award grants to counties only through grant 17041
agreements entered into under this section.17042

       (C) The director shall enter into one or more written grant 17043
agreements with the county grantees of each county. If a county 17044
has multiple county grantees, the director shall jointly enter 17045
into the grant agreement with all of the county grantees. The 17046
initial grant agreement shall be entered into not later than 17047
January 31, 2008, and shall be in effect for fiscal year 2009. 17048
Except as provided in rules adopted under this section, 17049
subsequent grant agreements shall be entered into before the 17050
first day of each successive fiscal biennial period and shall be 17051
in effect for that fiscal biennial period or, in the case of a 17052
grant agreement entered into after the first day of a fiscal 17053
biennial period and except as provided by section 5101.211 of the 17054
Revised Code, for the remainder of the fiscal biennial period. A 17055
grant agreement shall do all of the following:17056

       (1) Comply with all of the conditions, requirements, and 17057
restrictions applicable to the ODJFS family services duties for 17058
which the grants included in the agreement are awarded, including 17059
the conditions, requirements, and restrictions established by the 17060
department, federal or state law, state plans for receipt of 17061
federal financial participation, agreements between the department 17062
and a federal agency, and executive orders issued by the governor;17063

        (2) Establish terms and conditions governing the 17064
accountability for and use of the grants included in the grant 17065
agreement;17066

        (3) Specify both of the following:17067

       (a) The ODJFS family services duties for which the grants 17068
included in the agreement are awarded;17069

       (b) The private and government entities designated under 17070
section 307.981 of the Revised Code to serve as the county family 17071
services agencies performing the ODJFS family services duties;17072

       (4) Provide for the department of job and family services to 17073
award the grants included in the agreement in accordance with a 17074
methodology for determining the amount of the award established 17075
by rules adopted under this section;17076

       (5) Specify the form of the grants which may be a cash draw, 17077
reimbursement, property, advance, working capital advance, or 17078
other forms specified in rules adopted under this section;17079

       (6) Provide that the grants are subject to the availability 17080
of federal funds and appropriations made by the general assembly;17081

       (7) Specify annual financial, administrative, or other 17082
incentive awards, if any, to be provided in accordance with 17083
section 5101.23 of the Revised Code;17084

       (8) Include the assurance of each county grantee that the 17085
county grantee will do all of the following:17086

       (a) Ensure that the grants included in the agreement are 17087
used, and the ODJFS family services duties for which the grants 17088
are awarded are performed, in accordance with conditions, 17089
requirements, and restrictions applicable to the duties 17090
established by the department, a federal or state law, state 17091
plans for receipt of federal financial participation, agreements 17092
between the department and a federal agency, and executive orders 17093
issued by the governor;17094

       (b) Utilize a financial management system and other 17095
accountability mechanisms for the grants awarded under the 17096
agreement that meet requirements the department establishes;17097

       (c) Do all of the following with regard to a county 17098
subgrant:17099

       (i) Award the subgrant through a written county subgrant 17100
agreement that requires the entity awarded the county subgrant to 17101
comply with all conditions, requirements, and restrictions 17102
applicable to the county grantee regarding the grant that the 17103
county grantee subgrants to the entity, including the conditions, 17104
requirements, and restrictions of this section;17105

        (ii) Monitor the entity that is awarded the subgrant to 17106
ensure that the entity uses the subgrant in accordance with 17107
conditions, requirements, and restrictions applicable to the 17108
ODJFS family services duties for which the subgrant is awarded;17109

       (iii) Take action to recover subgrants that are not used in 17110
accordance with the conditions, requirements, or restrictions 17111
applicable to the ODJFS family services duties for which the 17112
subgrant is awarded.17113

       (d) Promptly reimburse the department the amount that 17114
represents the amount the county grantee is responsible for, 17115
pursuant to action the department takes under division (C) of 17116
section 5101.24 of the Revised Code, of funds the department pays 17117
to any entity because of an adverse audit finding, adverse 17118
quality control finding, final disallowance of federal financial 17119
participation, or other sanction or penalty;17120

       (e) Take prompt corrective action, including paying amounts 17121
resulting from an adverse finding, sanction, or penalty, if the 17122
department, auditor of state, federal agency, or other entity 17123
authorized by federal or state law to determine compliance with 17124
the conditions, requirements, and restrictions applicable to a17125
an ODJFS family services duty for which a grant included in the 17126
agreement is awarded determines compliance has not been 17127
achieved;17128

        (f) Ensure that any matching funds, regardless of the source, 17129
that the county grantee manages are clearly identified and used in 17130
accordance with federal and state laws and the agreement.17131

       (9) Provide for the department taking action pursuant to 17132
division (C) of section 5101.24 of the Revised Code if authorized 17133
by division (B)(1), (2), (3), or (4) of that section;17134

       (10) Provide for timely audits required by federal and 17135
state law and require prompt release of audit findings and prompt 17136
action to correct problems identified in an audit;17137

       (11) Provide for administrative review procedures in 17138
accordance with section 5101.24 of the Revised Code;17139

       (12) Establish the method of amending or terminating the 17140
agreement and an expedited process for correcting terms or 17141
conditions of the agreement that the director and each county 17142
grantee agree are erroneous.17143

       (D) A grant agreement does not have to be amended for a 17144
county grantee to be required to comply with a new or amended 17145
condition, requirement, or restriction for aan ODJFS family 17146
services duty established by federal or state law, state plan for 17147
receipt of federal financial participation, agreement between the 17148
department and a federal agency, or executive order issued by the 17149
governor.17150

        (E) The department shall make payments authorized by a grant 17151
agreement on vouchers it prepares and may include any funds 17152
appropriated or allocated to it for carrying out ODJFS family 17153
services duties for which a grant included in the agreement is 17154
awarded, including funds for personal services and maintenance.17155

       (F)(1) The director shall adopt rules in accordance with 17156
section 111.15 of the Revised Code governing grant agreements. 17157
The director shall adopt the rules as if they were internal 17158
management rules. Before adopting the rules, the director shall 17159
give the public an opportunity to review and comment on the 17160
proposed rules. The rules shall establish methodologies to be used 17161
to determine the amount of the grants included in the agreements. 17162
The rules also shall establish terms and conditions under which 17163
an agreement may be entered into after the first day of a fiscal 17164
biennial period. The rules may do any or all of the following:17165

       (a) Govern the award of grants included in grant agreements, 17166
including the establishment of, and restrictions on, the form of 17167
the grants and the distribution of the grants;17168

       (b) Specify allowable uses of the grants included in the 17169
agreements;17170

       (c) Establish reporting, cash management, audit, and other 17171
requirements the director determines are necessary to provide 17172
accountability for the use of the grants included in the 17173
agreements and determine compliance with conditions, 17174
requirements, and restrictions established by the department, a 17175
federal or state law, state plans for receipt of federal 17176
financial participation, agreements between the department and a 17177
federal agency, and executive orders issued by the governor.17178

       (2) A requirement of a grant agreement established by a rule 17179
adopted under this division is applicable to a grant agreement 17180
without having to be restated in the grant agreement. A 17181
requirement established by a grant agreement is applicable to the 17182
grant agreement without having to be restated in a rule.17183

       Sec. 5101.212.  The department of job and family services 17184
shall publish in a manner accessible to the public all of the 17185
following that concern ODJFS family services duties for which 17186
grants included in grant agreements entered into under section 17187
5101.21 of the Revised Code are awarded: state plans for receipt 17188
of federal financial participation, agreements between the 17189
department and a federal agency, and executive orders issued by 17190
the governor. The department may publish the materials 17191
electronically or otherwise.17192

       Sec. 5101.214.  The director of job and family services may 17193
enter into a written agreement with one or more state agencies, as 17194
defined in section 117.01 of the Revised Code, and state 17195
universities and colleges to assist in the coordination, 17196
provision, or enhancement of the ODJFS family services duties of a17197
county family services agency or the workforce development17198
activities of a workforce development agency. The director also 17199
may enter into written agreements or contracts with, or issue 17200
grants to, private and government entities under which funds are 17201
provided for the enhancement or innovation of ODJFS family 17202
services duties or workforce development activities on the state 17203
or local level.17204

       The director may adopt internal management rules in 17205
accordance with section 111.15 of the Revised Code to implement 17206
this section.17207

       Sec. 5101.216.  The director of job and family services may 17208
enter into one or more written operational agreements with boards 17209
of county commissioners to do one or more of the following 17210
regarding ODJFS family services duties:17211

       (A) Provide for the director to amend or rescind a rule the 17212
director previously adopted;17213

       (B) Provide for the director to modify procedures or 17214
establish alternative procedures to accommodate special 17215
circumstances in a county;17216

       (C) Provide for the director and board to jointly identify 17217
operational problems of mutual concern and develop a joint plan to 17218
address the problems;17219

       (D) Establish a framework for the director and board to 17220
modify the use of existing resources in a manner that is 17221
beneficial to the department of job and family services and the 17222
county that the board serves and improves ODJFS family services 17223
duties for the recipients of the services.17224

       Sec. 5101.22.  The department of job and family services may 17225
establish performance and other administrative standards for the17226
administration and outcomes of ODJFS family services duties and 17227
determine at intervals the department decides the degree to which 17228
a county family services agency complies with a performance or 17229
other administrative standard. The department may use statistical 17230
sampling, performance audits, case reviews, or other methods it 17231
determines necessary and appropriate to determine compliance with 17232
performance and administrative standards.17233

       Sec. 5101.221.  (A) Except as provided by division (C) of 17234
this section, if the department of job and family services 17235
determines that a county family services agency has failed to 17236
comply with a performance or other administrative standard 17237
established under section 5101.22 of the Revised Code or by 17238
federal law for the administration or outcome of aan ODJFS family 17239
services duty, the department shall require the agency to develop, 17240
submit to the department for approval, and comply with a 17241
corrective action plan.17242

       (B) If a county family services agency fails to develop, 17243
submit to the department, or comply with a corrective action plan 17244
under division (A) of this section, or the department disapproves 17245
the agency's corrective action plan, the department may require 17246
the agency to develop, submit to the department for approval, and 17247
comply with a corrective action plan that requires the agency to 17248
commit existing resources to the plan.17249

       (C) The department may not require a county family services 17250
agency to take action under this section for failure to comply 17251
with a performance or other administrative standard established 17252
for an incentive awarded by the department. Instead, the 17253
department may require a county family services agency that fails 17254
to comply with that kind of performance or other administrative 17255
standard to take action in accordance with rules adopted by the 17256
department governing the standard.17257

       (D) At the request of a county family services agency, the 17258
department shall assist the agency with the development of a 17259
corrective action plan under this section and provide the agency 17260
technical assistance in the implementation of the plan.17261

       Sec. 5101.23.  Subject to the availability of funds, the17262
department of job and family services may provide annual17263
financial, administrative, or other incentive awards to county 17264
family services agencies and workforce development agencies. A 17265
county family services agency or workforce development agency may 17266
spend funds provided as a financial incentive award only for the 17267
purpose for which the funds are appropriated. The department may 17268
adopt internal management rules in accordance with section 111.15 17269
of the Revised Code to establish the amounts of awards,17270
methodology for distributing the awards, types of awards, and 17271
standards for administration by the department.17272

       There is hereby created in the state treasury the social17273
services incentive fund. The director of job and family services 17274
may request that the director of budget and management transfer17275
funds in the Title IV-A reserve fund created under section 5101.82 17276
of the Revised Code and other funds appropriated for ODJFS family17277
services duties or workforce investment activities into the fund. 17278
If the director of budget and management determines that the funds17279
identified by the director of job and family services are17280
available and appropriate for transfer, the director of budget and 17281
management shall make the transfer. Money in the fund shall be 17282
used to provide incentive awards under this section.17283

       Sec. 5101.24.  (A) As used in this section, "responsible 17284
county grantee" means whichever county grantee, as defined in 17285
section 5101.21 of the Revised Code, the director of job and 17286
family services determines is appropriate to take action against 17287
under division (C) of this section.17288

       (B) Regardless of whether aan ODJFS family services duty is 17289
performed by a county family services agency, private or 17290
government entity pursuant to a contract entered into under 17291
section 307.982 of the Revised Code or division (C)(2) of section 17292
5153.16 of the Revised Code, or private or government provider of 17293
aan ODJFS family service duty, the department of job and family 17294
services may take action under division (C) of this section 17295
against the responsible county grantee if the department 17296
determines any of the following are the case:17297

       (1) A requirement of a grant agreement entered into under 17298
section 5101.21 of the Revised Code that includes a grant for the 17299
ODJFS family services duty, including a requirement for grant 17300
agreements established by rules adopted under that section, is 17301
not complied with;17302

       (2) A county family services agency fails to develop, submit 17303
to the department, or comply with a corrective action plan under 17304
division (B) of section 5101.221 of the Revised Code, or the 17305
department disapproves the agency's corrective action plan 17306
developed under division (B) of section 5101.221 of the Revised 17307
Code;17308

        (3) A requirement for the ODJFS family services duty17309
established by the department or any of the following is not 17310
complied with: a federal or state law, state plan for receipt of 17311
federal financial participation, grant agreement between the 17312
department and a federal agency, or executive order issued by the 17313
governor;17314

       (4) The responsible county grantee is solely or partially 17315
responsible, as determined by the director of job and family 17316
services, for an adverse audit finding, adverse quality control 17317
finding, final disallowance of federal financial participation, 17318
or other sanction or penalty regarding the ODJFS family services 17319
duty.17320

       (C) The department may take one or more of the following 17321
actions against the responsible county grantee when authorized by17322
division (B)(1), (2), (3), or (4) of this section:17323

       (1) Require the responsible county grantee to comply with a17324
corrective action plan pursuant to a time schedule specified by17325
the department. The corrective action plan shall be established 17326
or approved by the department and shall not require a county 17327
grantee to commit resources to the plan.17328

       (2) Require the responsible county grantee to comply with a 17329
corrective action plan pursuant to a time schedule specified by 17330
the department. The corrective action plan shall be established 17331
or approved by the department and require a county grantee to 17332
commit to the plan existing resources identified by the agency.17333

        (3) Require the responsible county grantee to do one of the 17334
following:17335

       (a) Share with the department a final disallowance of federal17336
financial participation or other sanction or penalty;17337

       (b) Reimburse the department the final amount the department 17338
pays to the federal government or another entity that represents 17339
the amount the responsible county grantee is responsible for of17340
an adverse audit finding, adverse quality control finding, final 17341
disallowance of federal financial participation, or other 17342
sanction or penalty issued by the federal government, auditor of 17343
state, or other entity;17344

       (c) Pay the federal government or another entity the final 17345
amount that represents the amount the responsible county grantee 17346
is responsible for of an adverse audit finding, adverse quality 17347
control finding, final disallowance of federal financial 17348
participation, or other sanction or penalty issued by the federal 17349
government, auditor of state, or other entity;17350

       (d) Pay the department the final amount that represents the 17351
amount the responsible county grantee is responsible for of an 17352
adverse audit finding or adverse quality control finding.17353

       (4) Impose an administrative sanction issued by the 17354
department against the responsible county grantee. A sanction may 17355
be increased if the department has previously taken action 17356
against the responsible entity under this division.17357

       (5) Perform, or contract with a government or private entity 17358
for the entity to perform, the ODJFS family services duty until17359
the department is satisfied that the responsible county grantee 17360
ensures that the duty will be performed satisfactorily. If the 17361
department performs or contracts with an entity to perform aan 17362
ODJFS family services duty under division (C)(5) of this section, 17363
the department may do either or both of the following:17364

       (a) Spend funds in the county treasury appropriated by the 17365
board of county commissioners for the duty;17366

       (b) Withhold funds allocated or reimbursements due to the 17367
responsible county grantee for the duty and spend the funds for 17368
the duty. 17369

       (6) Request that the attorney general bring mandamus17370
proceedings to compel the responsible county grantee to take or17371
cease the action that causes division (B)(1), (2), (3), or (4) of 17372
this section to apply. The attorney general shall bring mandamus 17373
proceedings in the Franklin county court of appeals at the 17374
department's request.17375

       (7) If the department takes action under this division 17376
because of division (B)(3) of this section, temporarily withhold 17377
funds allocated or reimbursement due to the responsible county 17378
grantee until the department determines that the responsible 17379
county grantee is in compliance with the requirement. The 17380
department shall release the funds when the department determines 17381
that compliance has been achieved.17382

       (D) If the department proposes to take action against the 17383
responsible county grantee under division (C) of this section, the 17384
department shall notify the responsible county grantee, director 17385
of the appropriate county family services agency, and county17386
auditor. The notice shall be in writing and specify the action 17387
the department proposes to take. The department shall send the 17388
notice by regular United States mail.17389

        Except as provided by division (E) of this section, the 17390
responsible county grantee may request an administrative review 17391
of a proposed action in accordance with administrative review 17392
procedures the department shall establish. The administrative 17393
review procedures shall comply with all of the following:17394

       (1) A request for an administrative review shall state 17395
specifically all of the following:17396

       (a) The proposed action specified in the notice from the 17397
department for which the review is requested;17398

       (b) The reason why the responsible county grantee believes 17399
the proposed action is inappropriate;17400

       (c) All facts and legal arguments that the responsible 17401
county grantee wants the department to consider;17402

       (d) The name of the person who will serve as the responsible 17403
county grantee's representative in the review.17404

       (2) If the department's notice specifies more than one 17405
proposed action and the responsible county grantee does not 17406
specify all of the proposed actions in its request pursuant to 17407
division (D)(1)(a) of this section, the proposed actions not 17408
specified in the request shall not be subject to administrative 17409
review and the parts of the notice regarding those proposed 17410
actions shall be final and binding on the responsible county 17411
grantee.17412

       (3) In the case of a proposed action under division (C)(1) of17413
this section, the responsible county grantee shall have fifteen 17414
calendar days after the department mails the notice to the 17415
responsible county grantee to send a written request to the 17416
department for an administrative review. If it receives such a17417
request within the required time, the department shall postpone17418
taking action under division (C)(1) of this section for fifteen 17419
calendar days following the day it receives the request or 17420
extended period of time provided for in division (D)(5) of this 17421
section to allow a representative of the department and a 17422
representative of the responsible county grantee an informal 17423
opportunity to resolve any dispute during that fifteen-day or 17424
extended period.17425

       (4) In the case of a proposed action under division (C)(2), 17426
(3), (4), (5), or (7) of this section, the responsible county 17427
grantee shall have thirty calendar days after the department 17428
mails the notice to the responsible county grantee to send a 17429
written request to the department for an administrative review. 17430
If it receives such a request within the required time, the 17431
department shall postpone taking action under division (C)(2), 17432
(3), (4), (5), or (7) of this section for thirty calendar days 17433
following the day it receives the request or extended period of 17434
time provided for in division (D)(5) of this section to allow a 17435
representative of the department and a representative of the 17436
responsible county grantee an informal opportunity to resolve 17437
any dispute during that thirty-day or extended period.17438

       (5) If the informal opportunity provided in division (D)(3) 17439
or (4) of this section does not result in a written resolution to 17440
the dispute within the fifteen- or thirty-day period, the director 17441
of job and family services and representative of the responsible 17442
county grantee may enter into a written agreement extending the 17443
time period for attempting an informal resolution of the dispute 17444
under division (D)(3) or (4) of this section.17445

        (6) In the case of a proposed action under division (C)(3) of 17446
this section, the responsible county grantee may not include in 17447
its request disputes over a finding, final disallowance of 17448
federal financial participation, or other sanction or penalty 17449
issued by the federal government, auditor of state, or entity 17450
other than the department.17451

       (7) If the responsible county grantee fails to request an 17452
administrative review within the required time, the responsible 17453
county grantee loses the right to request an administrative 17454
review of the proposed actions specified in the notice and the 17455
notice becomes final and binding on the responsible county 17456
grantee.17457

       (8) If the informal opportunity provided in division (D)(3) 17458
or (4) of this section does not result in a written resolution to 17459
the dispute within the time provided by division (D)(3), (4), or 17460
(5) of this section, the director shall appoint an administrative 17461
review panel to conduct the administrative review. The review 17462
panel shall consist of department employees and one director or 17463
other representative of the type of county family services agency 17464
that is responsible for the kind of ODJFS family services duty 17465
that is the subject of the dispute and serves a different county 17466
than the county served by the responsible county grantee. No 17467
individual involved in the department's proposal to take action 17468
against the responsible county grantee may serve on the review 17469
panel. The review panel shall review the responsible county 17470
grantee's request. The review panel may require that the 17471
department or responsible county grantee submit additional 17472
information and schedule and conduct an informal hearing to 17473
obtain testimony or additional evidence. A review of a proposal 17474
to take action under division (C)(3) of this section shall be 17475
limited solely to the issue of the amount the responsible county 17476
grantee shall share with the department, reimburse the 17477
department, or pay to the federal government, department, or 17478
other entity under division (C)(3) of this section. The review 17479
panel is not required to make a stenographic record of its 17480
hearing or other proceedings.17481

       (9) After finishing an administrative review, an 17482
administrative review panel appointed under division (D)(8) of 17483
this section shall submit a written report to the director setting 17484
forth its findings of fact, conclusions of law, and 17485
recommendations for action. The director may approve, modify, or 17486
disapprove the recommendations. If the director modifies or 17487
disapproves the recommendations, the director shall state the 17488
reasons for the modification or disapproval and the actions to be 17489
taken against the responsible county grantee.17490

       (10) The director's approval, modification, or disapproval 17491
under division (D)(9) of this section shall be final and binding 17492
on the responsible county grantee and shall not be subject to 17493
further departmental review.17494

       (E) The responsible county grantee is not entitled to an 17495
administrative review under division (D) of this section for any 17496
of the following:17497

       (1) An action taken under division (C)(6) of this section;17498

       (2) An action taken under section 5101.242 of the Revised 17499
Code;17500

       (3) An action taken under division (C)(3) of this section if 17501
the federal government, auditor of state, or entity other than the 17502
department has identified the responsible county grantee as being 17503
solely or partially responsible for an adverse audit finding, 17504
adverse quality control finding, final disallowance of federal 17505
financial participation, or other sanction or penalty;17506

       (4) An adjustment to an allocation, cash draw, advance, or 17507
reimbursement to a responsible county grantee that the department 17508
determines necessary for budgetary reasons;17509

       (5) Withholding of a cash draw or reimbursement due to 17510
noncompliance with a reporting requirement established in rules 17511
adopted under section 5101.243 of the Revised Code.17512

       (F) This section does not apply to other actions the 17513
department takes against the responsible county grantee pursuant 17514
to authority granted by another state law unless the other state 17515
law requires the department to take the action in accordance with 17516
this section.17517

       (G) The director of job and family services may adopt rules 17518
in accordance with Chapter 119. of the Revised Code as necessary 17519
to implement this section.17520

       Sec. 5101.243.  The director of job and family services may 17521
adopt rules in accordance with section 111.15 of the Revised Code 17522
establishing reporting requirements for ODJFS family services 17523
duties and workforce development activities. If the director 17524
adopts the rules, the director shall adopt the rules as if they 17525
were internal management rules and, before adopting the rules, 17526
give the public an opportunity to review and comment on the 17527
proposed rules.17528

       Sec. 5101.25.  The department of humanjob and family17529
services, in consultation with county representatives, shall 17530
develop annual training goals and model training curriculum 17531
regarding ODJFS family services duties for employees of county 17532
family services agencies and identify a variety of state funded 17533
training opportunities to meet the proposed goals.17534

       Sec. 5101.26.  As used in this section and in sections17535
5101.27 to 5101.30 of the Revised Code:17536

       (A) "County agency" means a county department of job and17537
family services or a public children services agency.17538

       (B) "Fugitive felon" means an individual who is fleeing to17539
avoid prosecution, or custody or confinement after conviction,17540
under the laws of the place from which the individual is fleeing,17541
for a crime or an attempt to commit a crime that is a felony under17542
the laws of the place from which the individual is fleeing or, in17543
the case of New Jersey, a high misdemeanor, regardless of whether17544
the individual has departed from the individual's usual place of17545
residence.17546

       (C) "Information" means records as defined in section 149.011 17547
of the Revised Code, any other documents in any format, and data 17548
derived from records and documents that are generated, acquired, 17549
or maintained by the department of job and family services, a 17550
county agency, or an entity performing duties on behalf of the17551
department or a county agency.17552

       (D) "Law enforcement agency" means the state highway patrol,17553
an agency that employs peace officers as defined in section 109.7117554
of the Revised Code, the adult parole authority, a county17555
department of probation, a prosecuting attorney, the attorney17556
general, similar agencies of other states, federal law enforcement17557
agencies, and postal inspectors. "Law enforcement agency" includes 17558
the peace officers and other law enforcement officers employed by 17559
the agency.17560

       (E) "Medical assistance provided under a public assistance 17561
program" means medical assistance provided under the programs 17562
established under sectionssection 5101.49, 5101.50 to 5101.503, 17563
5101.51 to 5101.5110, 5101.52 to 5101.529, and 5101.5211 to 17564
5101.5216, Chapters 5111. and 5115., or any other provision of 17565
the Revised Code that the department of job and family services 17566
administers.17567

        (F) "Public assistance" means financial assistance, medical17568
assistance, or social services provided under a program17569
administered by the department of job and family services or a17570
county agency pursuant to Chapter 329., 5101., 5104., 5107.,17571
5108., 5111., or 5115. of the Revised Code or an executive order17572
issued under section 107.17 of the Revised Code.17573

       (G) "Public assistance recipient" means an applicant for or17574
recipient or former recipient of public assistance.17575

       Sec. 5101.35.  (A) As used in this section:17576

       (1) "Agency" means the following entities that administer a17577
family services program:17578

       (a) The department of job and family services;17579

       (b) A county department of job and family services;17580

       (c) A public children services agency;17581

       (d) A private or government entity administering, in whole or 17582
in part, a family services program for or on behalf of the17583
department of job and family services or a county department of17584
job and family services or public children services agency.17585

       (2) "Appellant" means an applicant, participant, former17586
participant, recipient, or former recipient of a family services17587
program who is entitled by federal or state law to a hearing17588
regarding a decision or order of the agency that administers the17589
program.17590

       (3) "Family services program" means assistance provided under17591
a Title IV-A program as defined in section 5101.80 of the Revised 17592
Code or under Chapter 5104., 5111., or 5115. or section 173.3517593
5160.80, 5101.141, 5101.46, 5101.461, 5101.54, 5153.163, or17594
5153.165 of the Revised Code, other than assistance provided under17595
section 5101.46 of the Revised Code by the department of mental17596
health, the department of mental retardation and developmental17597
disabilities, a board of alcohol, drug addiction, and mental17598
health services, or a county board of mental retardation and17599
developmental disabilities.17600

       (B) Except as provided by divisionsdivision (G) and (H) of 17601
this section, an appellant who appeals under federal or state law 17602
a decision or order of an agency administering a family services17603
program shall, at the appellant's request, be granted a state 17604
hearing by the department of job and family services. This state 17605
hearing shall be conducted in accordance with rules adopted under 17606
this section. The state hearing shall be recorded, but neither the17607
recording nor a transcript of the recording shall be part of the17608
official record of the proceeding. A state hearing decision is17609
binding upon the agency and department, unless it is reversed or17610
modified on appeal to the director of job and family services or a17611
court of common pleas.17612

       (C) Except as provided by division (G) of this section, an17613
appellant who disagrees with a state hearing decision may make an17614
administrative appeal to the director of job and family services17615
in accordance with rules adopted under this section. This17616
administrative appeal does not require a hearing, but the director17617
or the director's designee shall review the state hearing decision17618
and previous administrative action and may affirm, modify, remand,17619
or reverse the state hearing decision. Any person designated to17620
make an administrative appeal decision on behalf of the director17621
shall have been admitted to the practice of law in this state. An17622
administrative appeal decision is the final decision of the17623
department and is binding upon the department and agency, unless17624
it is reversed or modified on appeal to the court of common pleas.17625

       (D) An agency shall comply with a decision issued pursuant to17626
division (B) or (C) of this section within the time limits17627
established by rules adopted under this section. If a county17628
department of job and family services or a public children17629
services agency fails to comply within these time limits, the17630
department may take action pursuant to section 5101.24 of the17631
Revised Code. If another agency fails to comply within the time17632
limits, the department may force compliance by withholding funds17633
due the agency or imposing another sanction established by rules17634
adopted under this section.17635

       (E) An appellant who disagrees with an administrative appeal17636
decision of the director of job and family services or the17637
director's designee issued under division (C) of this section may17638
appeal from the decision to the court of common pleas pursuant to17639
section 119.12 of the Revised Code. The appeal shall be governed17640
by section 119.12 of the Revised Code except that:17641

       (1) The person may appeal to the court of common pleas of the 17642
county in which the person resides, or to the court of common17643
pleas of Franklin county if the person does not reside in this17644
state.17645

       (2) The person may apply to the court for designation as an17646
indigent and, if the court grants this application, the appellant17647
shall not be required to furnish the costs of the appeal.17648

       (3) The appellant shall mail the notice of appeal to the17649
department of job and family services and file notice of appeal17650
with the court within thirty days after the department mails the17651
administrative appeal decision to the appellant. For good cause17652
shown, the court may extend the time for mailing and filing notice17653
of appeal, but such time shall not exceed six months from the date17654
the department mails the administrative appeal decision. Filing17655
notice of appeal with the court shall be the only act necessary to17656
vest jurisdiction in the court.17657

       (4) The department shall be required to file a transcript of17658
the testimony of the state hearing with the court only if the17659
court orders the department to file the transcript. The court17660
shall make such an order only if it finds that the department and17661
the appellant are unable to stipulate to the facts of the case and17662
that the transcript is essential to a determination of the appeal.17663
The department shall file the transcript not later than thirty17664
days after the day such an order is issued.17665

       (F) The department of job and family services shall adopt17666
rules in accordance with Chapter 119. of the Revised Code to17667
implement this section, including rules governing the following:17668

       (1) State hearings under division (B) of this section. The17669
rules shall include provisions regarding notice of eligibility17670
termination and the opportunity of an appellant appealing a17671
decision or order of a county department of job and family17672
services to request a county conference with the county department17673
before the state hearing is held.17674

       (2) Administrative appeals under division (C) of this17675
section;17676

       (3) Time limits for complying with a decision issued under17677
division (B) or (C) of this section;17678

       (4) Sanctions that may be applied against an agency under17679
division (D) of this section.17680

       (G) The department of job and family services may adopt rules17681
in accordance with Chapter 119. of the Revised Code establishing 17682
an appeals process for an appellant who appeals a decision or17683
order regarding a Title IV-A program identified under division17684
(A)(4)(c), (d), (e), or (f) of section 5101.80 of the Revised Code 17685
that is different from the appeals process established by this 17686
section. The different appeals process may include having a state 17687
agency that administers the Title IV-A program pursuant to an 17688
interagency agreement entered into under section 5101.801 of the 17689
Revised Code administer the appeals process.17690

       (H) If an appellant receiving medicaid through a health 17691
insuring corporation that holds a certificate of authority under 17692
Chapter 1751. of the Revised Code is appealing a denial of 17693
medicaid services based on lack of medical necessity or other 17694
clinical issues regarding coverage by the health insuring 17695
corporation, the person hearing the appeal may order an 17696
independent medical review if that person determines that a review 17697
is necessary. The review shall be performed by a health care 17698
professional with appropriate clinical expertise in treating the 17699
recipient's condition or disease. The department shall pay the 17700
costs associated with the review.17701

       A review ordered under this division shall be part of the 17702
record of the hearing and shall be given appropriate evidentiary 17703
consideration by the person hearing the appeal.17704

       (I) The requirements of Chapter 119. of the Revised Code17705
apply to a state hearing or administrative appeal under this17706
section only to the extent, if any, specifically provided by rules17707
adopted under this section.17708

       Sec. 5101.36.  Any application for public assistance gives a17709
right of subrogation to the department of job and family services17710
for any workers' compensation benefits payable to a person who is17711
subject to a support order, as defined in section 3119.01 of the17712
Revised Code, on behalf of the applicant, to the extent of any17713
public assistance payments made on the applicant's behalf. If the17714
director of job and family services, in consultation with a child17715
support enforcement agency and the administrator of the bureau of17716
workers' compensation, determines that a person responsible for17717
support payments to a recipient of public assistance is receiving17718
workers' compensation, the director shall notify the administrator17719
of the amount of the benefit to be paid to the department of job17720
and family services.17721

       For purposes of this section, "public assistance" means17722
medical assistance provided through the medical assistance program17723
established under section 5111.01 of the Revised Code; Ohio works17724
first provided under Chapter 5107. of the Revised Code;17725
prevention, retention, and contingency benefits and services17726
provided under Chapter 5108. of the Revised Code; or disability 17727
financial assistance provided under Chapter 5115. of the Revised17728
Code; or disability medical assistance provided under Chapter 17729
5115. of the Revised Code.17730

       Sec. 5101.47.  (A) Except as provided in division (B) of 17731
this section, the director of job and family services may accept 17732
applications, determine eligibility, redetermine eligibility, and 17733
perform related administrative activities for one or more of the 17734
following:17735

       (1) The medicaid program established by Chapter 5111. of the17736
Revised Code;17737

       (2) The children's health insurance program parts I, II, and 17738
III provided for under sections 5101.50, 5101.51, and 5101.52 of 17739
the Revised Code;17740

       (3) Publicly funded child care provided under Chapter 5104.17741
of the Revised Code;17742

       (4)(2) The food stamp program administered by the department 17743
of job and family services pursuant to section 5101.54 of the 17744
Revised Code;17745

       (5)(3) Other programs the director determines are supportive 17746
of children, adults, or families;17747

       (6)(4) Other programs regarding which the director determines 17748
administrative cost savings and efficiency may be achieved through 17749
the department accepting applications, determining eligibility, 17750
redetermining eligibility, or performing related administrative 17751
activities.17752

       (B) If federal law requires a face-to-face interview to 17753
complete an eligibility determination for a program specified in 17754
or pursuant to division (A) of this section, the face-to-face 17755
interview shall not be conducted by the department of job and 17756
family services.17757

       (C) Subject to division (B) of this section, if the director 17758
elects to accept applications, determine eligibility, redetermine 17759
eligibility, and perform related administrative activities for a 17760
program specified in or pursuant to division (A) of this section,17761
both of the following apply:17762

       (1) An individual seeking services under the program may 17763
apply for the program to the director or to the entity that state 17764
law governing the program authorizes to accept applications for 17765
the program.17766

       (2) The director is subject to federal statutes and 17767
regulations and state statutes and rules that require, permit, or 17768
prohibit an action regarding accepting applications, determining 17769
or redetermining eligibility, and performing related 17770
administrative activities for the program.17771

       (D) The director may adopt rules as necessary to implement 17772
this section.17773

       Sec. 5101.97.  (A)(1) Not later than the last day of each 17774
July and January, the department of job and family services shall 17775
complete a report on the characteristics of the individuals who 17776
participate in or receive services through the programs operated 17777
by the department and the outcomes of the individuals' 17778
participation in or receipt of services through the programs. The 17779
reports shall be for the six-month periods ending on the last days 17780
of June and December and shall include information on the 17781
following:17782

       (a) Work activities, developmental activities, and 17783
alternative work activities established under sections 5107.40 to 17784
5107.69 of the Revised Code;17785

       (b) Programs of publicly funded child care, as defined in 17786
section 5104.01 of the Revised Code;17787

       (c) Child support enforcement programs;17788

       (d) Births to recipients of the medical assistance program17789
established under Chapter 5111. of the Revised Code.17790

       (2) The department shall submit the reports required under 17791
division (A)(1) of this section to the speaker and minority leader 17792
of the house of representatives, the president and minority leader 17793
of the senate, the legislative budget officer, the director of 17794
budget and management, and each board of county commissioners. The17795
department shall provide copies of the reports to any person or17796
government entity on request.17797

       In designing the format for the reports, the department shall 17798
consult with individuals, organizations, and government entities 17799
interested in the programs operated by the department, so that the 17800
reports are designed to enable the general assembly and the public 17801
to evaluate the effectiveness of the programs and identify any 17802
needs that the programs are not meeting.17803

       (B) Whenever the federal government requires that the 17804
department submit a report on a program that is operated by the 17805
department or is otherwise under the department's jurisdiction, 17806
the department shall prepare and submit the report in accordance 17807
with the federal requirements applicable to that report. To the 17808
extent possible, the department may coordinate the preparation and 17809
submission of a particular report with any other report, plan, or 17810
other document required to be submitted to the federal government, 17811
as well as with any report required to be submitted to the general17812
assembly. The reports required by the Personal Responsibility and17813
Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) may be 17814
submitted as an annual summary.17815

       Sec. 5103.02.  As used in sections 5103.03 to 5103.17 of the 17816
Revised Code:17817

       (A) "Association" or "institution" includes any incorporated 17818
or unincorporated organization, society, association, or agency, 17819
public or private, that receives or cares for children for two or 17820
more consecutive weeks; any individual, including the operator of 17821
a foster home, who, for hire, gain, or reward, receives or cares17822
for children for two or more consecutive weeks, unless the 17823
individual is related to them by blood or marriage; and any 17824
individual not in the regular employ of a court, or of an17825
institution or association certified in accordance with section17826
5103.03 of the Revised Code, who in any manner becomes a party to17827
the placing of children in foster homes, unless the individual is17828
related to such children by blood or marriage, or is the appointed 17829
guardian of such children; provided, that any organization, 17830
society, association, school, agency, child guidance center, 17831
detention or rehabilitation facility, or children's clinic 17832
licensed, regulated, approved, operated under the direction of, or17833
otherwise certified by the department of education, a local board17834
of education, the department of youth services, the department of17835
mental health, or the department of mental retardation and17836
developmental disabilities, or any individual who provides care17837
for only a single-family group, placed there by their parents or17838
other relative having custody, shall not be considered as being17839
within the purview of these sections.17840

       (B) "Family foster home" means a foster home that is not a 17841
specialized foster home.17842

       (C) "Foster caregiver" means a person holding a valid foster 17843
home certificate issued under section 5103.03 of the Revised Code.17844

       (D) "Foster home" means a private residence in which children 17845
are received apart from their parents, guardian, or legal 17846
custodian, by an individual reimbursed for providing the children 17847
nonsecure care, supervision, or training twenty-four hours a day. 17848
"Foster home" does not include care provided for a child in the 17849
home of a person other than the child's parent, guardian, or legal 17850
custodian while the parent, guardian, or legal custodian is17851
temporarily away. Family foster homes and specialized foster homes17852
are types of foster homes.17853

       (E) "Medically fragile foster home" means a foster home that 17854
provides specialized medical services designed to meet the needs 17855
of children with intensive health care needs who meet all of the 17856
following criteria:17857

       (1) Under rules adopted by the departmentdirector of job and17858
family serviceshealth care administration governing payment under 17859
Chapter 5111. of the Revised Codethe medicaid program for 17860
long-term care services, the children require a skilled level of 17861
care.17862

       (2) The children require the services of a doctor of medicine 17863
or osteopathic medicine at least once a week due to the 17864
instability of their medical conditions.17865

       (3) The children require the services of a registered nurse 17866
on a daily basis.17867

       (4) The children are at risk of institutionalization in a 17868
hospital, skilled nursing facility, or intermediate care facility 17869
for the mentally retarded.17870

       (F) "Recommending agency" means a public children services17871
agency, private child placing agency, or private noncustodial 17872
agency that recommends that the department of job and family 17873
services take any of the following actions under section 5103.03 17874
of the Revised Code regarding a foster home:17875

       (1) Issue a certificate;17876

       (2) Deny a certificate;17877

       (3) Renew a certificate;17878

       (4) Deny renewal of a certificate;17879

       (5) Revoke a certificate.17880

       (G) "Specialized foster home" means a medically fragile 17881
foster home or a treatment foster home.17882

       (H) "Treatment foster home" means a foster home that17883
incorporates special rehabilitative services designed to treat the 17884
specific needs of the children received in the foster home and 17885
that receives and cares for children who are emotionally or 17886
behaviorally disturbed, chemically dependent, mentally retarded, 17887
developmentally disabled, or who otherwise have exceptional needs.17888

       Sec. 5107.10.  (A) As used in this section:17889

       (1) "Countable income," "gross earned income," and "gross17890
unearned income" have the meanings established in rules adopted17891
under section 5107.05 of the Revised Code.17892

       (2) "Federal poverty guidelines" has the same meaning as in 17893
section 5101.46 of the Revised Code, except that references to a 17894
person's family in the definition shall be deemed to be references 17895
to the person's assistance group.17896

       (3) "Gross income" means gross earned income and gross17897
unearned income.17898

        (4) "Strike" means continuous concerted action in failing to17899
report to duty; willful absence from one's position; or stoppage17900
of work in whole from the full, faithful, and proper performance17901
of the duties of employment, for the purpose of inducing,17902
influencing, or coercing a change in wages, hours, terms, and17903
other conditions of employment. "Strike" does not include a17904
stoppage of work by employees in good faith because of dangerous17905
or unhealthful working conditions at the place of employment that17906
are abnormal to the place of employment.17907

       (B) Under the Ohio works first program, an assistance group17908
shall receive, except as otherwise provided by this chapter,17909
time-limited cash assistance. In the case of an assistance group17910
that includes a minor head of household or adult, assistance shall17911
be provided in accordance with the self-sufficiency contract17912
entered into under section 5107.14 of the Revised Code.17913

       (C) To be eligible to participate in Ohio works first, an17914
assistance group must meet all of the following requirements:17915

       (1) The assistance group, except as provided in division (E)17916
of this section, must include at least one of the following:17917

       (a) A minor child who, except as provided in section 5107.2417918
of the Revised Code, resides with a parent, or specified relative17919
caring for the child, or, to the extent permitted by Title IV-A17920
and federal regulations adopted until Title IV-A, resides with a17921
guardian or custodian caring for the child;17922

       (b) A parent residing with and caring for the parent's minor17923
child who receives benefits under the supplemental security income 17924
under Title XVI of the "Social Security Act," 86 Stat. 1475 17925
(1972), 42 U.S.C.A. 1383, as amended,program or federal, state, 17926
or local adoption assistance;17927

       (c) A specified relative residing with and caring for a minor 17928
child who is related to the specified relative in a manner that 17929
makes the specified relative a specified relative and receives 17930
supplemental security income or federal, state, or local foster 17931
care or adoption assistance;17932

       (d) A woman at least six months pregnant.17933

       (2) The assistance group must meet the income requirements17934
established by division (D) of this section.17935

       (3) No member of the assistance group may be involved in a17936
strike.17937

       (4) The assistance group must satisfy the requirements for17938
Ohio works first established by this chapter and sections 5101.58, 17939
5101.59, and 5101.83, 5160.37, and 5160.38 of the Revised Code.17940

       (5) The assistance group must meet requirements for Ohio17941
works first established by rules adopted under section 5107.05 of17942
the Revised Code.17943

       (D)(1) Except as provided in division (D)(4) of this section, 17944
to determine whether an assistance group is initially eligible to 17945
participate in Ohio works first, a county department of job and 17946
family services shall do the following:17947

       (a) Determine whether the assistance group's gross income17948
exceeds fifty per cent of the federal poverty guidelines. In 17949
making this determination, the county department shall disregard 17950
amounts that federal statutes or regulations and sections 5101.17 17951
and 5117.10 of the Revised Code require be disregarded. The 17952
assistance group is ineligible to participate in Ohio works first17953
if the assistance group's gross income, less the amounts 17954
disregarded, exceeds fifty per cent of the federal poverty 17955
guidelines.17956

       (b) If the assistance group's gross income, less the amounts17957
disregarded pursuant to division (D)(1)(a) of this section, does17958
not exceed fifty per cent of the federal poverty guidelines,17959
determine whether the assistance group's countable income is less 17960
than the payment standard. The assistance group is ineligible to17961
participate in Ohio works first if the assistance group's17962
countable income equals or exceeds the payment standard.17963

       (2) For the purpose of determining whether an assistance 17964
group meets the income requirement established by division 17965
(D)(1)(a) of this section, the annual revision that the United 17966
States department of health and human services makes to the 17967
federal poverty guidelines shall go into effect on the first day 17968
of July of the year for which the revision is made.17969

       (3) To determine whether an assistance group participating in 17970
Ohio works first continues to be eligible to participate, a county 17971
department of job and family services shall determine whether the 17972
assistance group's countable income continues to be less than the 17973
payment standard. In making this determination, the county 17974
department shall disregard the first two hundred fifty dollars and 17975
fifty per cent of the remainder of the assistance group's gross 17976
earned income. No amounts shall be disregarded from the assistance17977
group's gross unearned income. The assistance group ceases to be 17978
eligible to participate in Ohio works first if its countable 17979
income, less the amounts disregarded, equals or exceeds the 17980
payment standard.17981

       (4) If an assistance group reapplies to participate in Ohio17982
works first not more than four months after ceasing to17983
participate, a county department of job and family services shall17984
use the income requirement established by division (D)(3) of this17985
section to determine eligibility for resumed participation rather17986
than the income requirement established by division (D)(1) of this17987
section.17988

       (E)(1) An assistance group may continue to participate in17989
Ohio works first even though a public children services agency17990
removes the assistance group's minor children from the assistance17991
group's home due to abuse, neglect, or dependency if the agency17992
does both of the following:17993

       (a) Notifies the county department of job and family services 17994
at the time the agency removes the children that it believes the 17995
children will be able to return to the assistance group within six 17996
months;17997

       (b) Informs the county department at the end of each of the17998
first five months after the agency removes the children that the17999
parent, guardian, custodian, or specified relative of the children18000
is cooperating with the case plans prepared for the children under18001
section 2151.412 of the Revised Code and that the agency is making18002
reasonable efforts to return the children to the assistance group.18003

       (2) An assistance group may continue to participate in Ohio18004
works first pursuant to division (E)(1) of this section for not18005
more than six payment months. This division does not affect the18006
eligibility of an assistance group that includes a woman at least18007
six months pregnant.18008

       Sec. 5107.14.  (A) An assistance group is ineligible to18009
participate in Ohio works first unless the following enter into a 18010
written self-sufficiency contract with the county department of18011
job and family services not later than thirty days after the 18012
assistance group applies for or undergoes a redetermination of 18013
eligibility for the program:18014

       (1) Each adult member of the assistance group;18015

       (2) The assistance group's minor head of household unless the 18016
minor head of household is participating in the LEAP program.18017

       (B) A self-sufficiency contract shall set forth the rights 18018
and responsibilities of the assistance group as applicants for and18019
participants of Ohio works first. Each self-sufficiency contract 18020
shall include, based on appraisals conducted under section 18021
5107.41 of the Revised Code and assessments conducted under 18022
section 5107.70 of the Revised Code, the following:18023

       (1) The assistance group's plan, developed under section18024
5107.41 of the Revised Code, to achieve the goal of self18025
sufficiency and personal responsibility through unsubsidized18026
employment within the time limit for participating in Ohio works18027
first established by section 5107.18 of the Revised Code;18028

       (2) Work activities, developmental activities, and18029
alternative work activities to which members of the assistance18030
group are assigned under sections 5107.40 to 5107.69 of the18031
Revised Code;18032

       (3) The responsibility of a caretaker member of the18033
assistance group to cooperate in establishing a minor child's18034
paternity and establishing, modifying, and enforcing a support18035
order for the child in accordance with section 5107.22 of the18036
Revised Code;18037

       (4) Other responsibilities that members of the assistance18038
group must satisfy to participate in Ohio works first and the18039
consequences for failure or refusal to satisfy the18040
responsibilities;18041

       (5) An agreement that, except as otherwise provided in a 18042
waiver issued under section 5107.714 of the Revised Code, the 18043
assistance group will comply with the conditions of participating 18044
in Ohio works first established by this chapter and sections 18045
5101.58, 5101.59, and 5101.83, 5160.37 and 5160.38 of the Revised18046
Code;18047

       (6) Assistance and services the county department will18048
provide to the assistance group;18049

       (7) Assistance and services the child support enforcement18050
agency and public children services agency will provide to the18051
assistance group pursuant to a plan of cooperation entered into18052
under section 307.983 of the Revised Code;18053

       (8) Other provisions designed to assist the assistance group18054
in achieving self sufficiency and personal responsibility;18055

       (9) Procedures for assessing whether responsibilities are18056
being satisfied and whether the contract should be amended;18057

       (10) Procedures for amending the contract.18058

       (C) No self-sufficiency contract shall include provisions 18059
regarding the LEAP program.18060

       (D) The county department shall provide without charge a copy 18061
of the self-sufficiency contract to each assistance group member 18062
who signs it.18063

       Sec. 5107.16.  (A) If a member of an assistance group fails 18064
or refuses, without good cause, to comply in full with a provision 18065
of a self-sufficiency contract entered into under section 5107.14 18066
of the Revised Code, a county department of job and family18067
services shall sanction the assistance group as follows:18068

       (1) For a first failure or refusal, the county department18069
shall deny or terminate the assistance group's eligibility to18070
participate in Ohio works first for one payment month;18071

       (2) For a second failure or refusal, the county department 18072
shall deny or terminate the assistance group's eligibility to18073
participate in Ohio works first for three payment months;18074

       (3) For a third or subsequent failure or refusal, the county 18075
department shall deny or terminate the assistance group's18076
eligibility to participate in Ohio works first for six payment18077
months.18078

       (B) The director of job and family services shall establish18079
standards for the determination of good cause for failure or 18080
refusal to comply in full with a provision of a self-sufficiency 18081
contract in rules adopted under section 5107.05 of the Revised 18082
Code.18083

       (C) After sanctioning an assistance group under division (A) 18084
of this section, a county department of job and family services 18085
shall continue to work with the assistance group.18086

       (D) An adult eligible for the medicaid program pursuant to18087
division (A)(1)(a) of section 5111.015162.01 of the Revised Code 18088
who is sanctioned under division (A)(3) of this section for a 18089
failure or refusal, without good cause, to comply in full with a 18090
provision of a self-sufficiency contract related to work18091
responsibilities under sections 5107.40 to 5107.69 of the Revised 18092
Code loses eligibility for the medicaid program unless the adult 18093
is otherwise eligible for the medicaid program pursuant to 18094
another division of section 5111.015162.01 of the Revised Code.18095

        An assistance group that would be participating in Ohio 18096
works first if not for a sanction under this section shall18097
continue to be eligible for all of the following:18098

       (1) Publicly funded child care in accordance with division18099
(A)(3) of section 5104.30 of the Revised Code;18100

       (2) Support services in accordance with section 5107.66 of 18101
the Revised Code;18102

       (3) To the extent permitted by the "Fair Labor Standards Act 18103
of 1938," 52 Stat. 1060, 29 U.S.C. 201, as amended, to 18104
participate in work activities, developmental activities, and 18105
alternative work activities in accordance with sections 5107.40 to 18106
5107.69 of the Revised Code.18107

       Sec. 5107.20.  As used in this section, "support" means18108
child support, spousal support, and support for a spouse or a18109
former spouse.18110

       Participation in Ohio works first constitutes an assignment18111
to the department of job and family services of any rights members18112
of an assistance group have to support from any other person,18113
excluding medical support assigned pursuant to section 5101.5918114
5160.37 of the Revised Code. The rights to support assigned to the18115
department pursuant to this section constitute an obligation of18116
the person who is responsible for providing the support to the18117
state for the amount of cash assistance provided to the assistance18118
group.18119

       The office of child support in the department of job and18120
family services shall collect and distribute support payments owed18121
to Ohio works first participants, whether assigned to the18122
department or unassigned, in accordance with 42 U.S.C. 654 B and18123
657 and regulations adopted under those statutes, state statutes,18124
and rules adopted under section 5107.05 of the Revised Code.18125

       Upon implementation of centralized collection and18126
disbursement under Chapter 3121. of the Revised Code, in18127
accordance with 42 U.S.C. 654 B and 657 and regulations adopted18128
under those statutes, the department shall deposit support18129
payments it receives pursuant to this section into the state18130
treasury to the credit of the child support collections fund or18131
the child support administrative fund, both of which are hereby18132
created. Money credited to the funds shall be used to make cash18133
assistance payments under Ohio works first.18134

       Sec. 5107.26.  (A) As used in this section:18135

       (1) "Transitional child care" means publicly funded child 18136
care provided under division (A)(3) of section 5104.34 of the 18137
Revised Code.18138

       (2) "Transitional medicaid" means the medical assistance 18139
provided under the medicaid program pursuant to section 5111.011518140
5162.09 of the Revised Code.18141

       (B) Except as provided in division (C) of this section, each 18142
member of an assistance group participating in Ohio works first is 18143
ineligible to participate in the program for six payment months if 18144
a county department of job and family services determines that a18145
member of the assistance group terminated the member's employment 18146
and each person who, on the day prior to the day a recipient 18147
begins to receive transitional child care or transitional18148
medicaid, was a member of the recipient's assistance group is 18149
ineligible to participate in Ohio works first for six payment18150
months if a county department determines that the recipient 18151
terminated the recipient's employment.18152

       (C) No assistance group member shall lose or be denied 18153
eligibility to participate in Ohio works first pursuant to 18154
division (B) of this section if the termination of employment was 18155
because an assistance group member or recipient of transitional 18156
child care or transitional medicaid secured comparable or better 18157
employment or the county department of job and family services 18158
certifies that the member or recipient terminated the employment18159
with just cause.18160

       Just cause includes the following:18161

       (1) Discrimination by an employer based on age, race, sex, 18162
color, handicap, religious beliefs, or national origin;18163

       (2) Work demands or conditions that render continued18164
employment unreasonable, such as working without being paid on18165
schedule;18166

       (3) Employment that has become unsuitable due to any of the 18167
following:18168

       (a) The wage is less than the federal minimum wage;18169

       (b) The work is at a site subject to a strike or lockout, 18170
unless the strike has been enjoined under section 208 of the 18171
"Labor-Management Relations Act," 61 Stat. 155 (1947), 29 U.S.C.A.18172
178, as amended, an injunction has been issued under section 10 of 18173
the "Railway Labor Act," 44 Stat. 586 (1926), 45 U.S.C.A. 160, as 18174
amended, or an injunction has been issued under section 4117.16 of 18175
the Revised Code;18176

       (c) The documented degree of risk to the member or 18177
recipient's health and safety is unreasonable;18178

       (d) The member or recipient is physically or mentally unfit 18179
to perform the employment, as documented by medical evidence or by 18180
reliable information from other sources.18181

       (4) Documented illness of the member or recipient or of 18182
another assistance group member of the member or recipient 18183
requiring the presence of the member or recipient;18184

       (5) A documented household emergency;18185

       (6) Lack of adequate child care for children of the member or 18186
recipient who are under six years of age.18187

       Sec. 5115.02.  (A) An individual is not eligible for 18188
disability financial assistance under this chapter if any of the 18189
following apply:18190

       (1) The individual is eligible to participate in the Ohio 18191
works first program established under Chapter 5107. of the Revised 18192
Code; eligible to receivefor the supplemental security income 18193
provided pursuant to Title XVI of the "Social Security Act," 86 18194
Stat. 1475 (1972), 42 U.S.C. 1383, as amendedprogram; or eligible 18195
to participate in or receive assistance through another state or 18196
federal program that provides financial assistance similar to 18197
disability financial assistance, as determined by the director of 18198
job and family services;18199

       (2) The individual is ineligible to participate in the Ohio18200
works first program because of any of the following:18201

       (a) The time limit established by section 5107.18 of the 18202
Revised Code;18203

       (b) Failure to comply with an application or verification 18204
procedure;18205

       (c) The fraud control provisions of section 5101.83 of the 18206
Revised Code or the fraud control program established pursuant to 18207
45 C.F.R. 235.112, as in effect July 1, 1996;18208

       (d) The self-sufficiency contract provisions of sections 18209
5107.14 and 5107.16 of the Revised Code;18210

       (e) The minor parent provisions of section 5107.24 of the 18211
Revised Code;18212

       (f) The provisions of section 5107.26 of the Revised Code 18213
regarding termination of employment without just cause.18214

       (3) The individual, or any of the other individuals included 18215
in determining the individual's eligibility, is involved in a 18216
strike, as defined in section 5107.10 of the Revised Code;18217

       (4) For the purpose of avoiding consideration of property in18218
determinations of the individual's eligibility for disability 18219
financial assistance or a greater amount of assistance, the 18220
individual has transferred property during the two years preceding 18221
application for or most recent redetermination of eligibility for 18222
disability assistance;18223

       (5) The individual is a child and does not live with the 18224
child's parents, guardians, or other persons standing in place of 18225
parents, unless the child is emancipated by being married, by 18226
serving in the armed forces, or by court order;18227

       (6) The individual resideresides in a county home, city 18228
infirmary, jail, or public institution;18229

       (7) The individual is a fugitive felon as defined in section 18230
5101.26 of the Revised Code;18231

       (8) The individual is violating a condition of probation, a18232
community control sanction, parole, or a post-release control 18233
sanction imposed under federal or state law.18234

       (B)(1) As used in division (B)(2) of this section, 18235
"assistance group" has the same meaning as in section 5107.02 of 18236
the Revised Code.18237

       (2) Ineligibility under division (A)(2)(c) or (d) of this 18238
section applies as follows:18239

       (a) In the case of an individual who is under eighteen years 18240
of age, the individual is ineligible only if the individual caused 18241
the assistance group to be ineligible to participate in the Ohio 18242
works first program or resides with an individual eighteen years 18243
of age or older who was a member of the same ineligible assistance 18244
group.18245

       (b) In the case of an individual who is eighteen years of age 18246
or older, the individual is ineligible regardless of whether the 18247
individual caused the assistance group to be ineligible to 18248
participate in the Ohio works first program.18249

       Sec. 5115.20.  (A) The department of job and family services 18250
shall establish a disability advocacy program and each county 18251
department of job and family services shall establish a disability 18252
advocacy program unit or join with other county departments of job 18253
and family services to establish a joint county disability 18254
advocacy program unit. Through the program the department and 18255
county departments shall cooperate in efforts to assist applicants 18256
for and recipients of assistance under the disability financial 18257
assistance program and the disability medical assistance program, 18258
who might be eligible for benefits under the supplemental security 18259
income benefits under Title XVI of the "Social Security Act," 86 18260
Stat. 1475 (1972), 42 U.S.C.A. 1383, as amendedprogram, in 18261
applying for those benefits. The department of health care 18262
administration shall assist the department of job and family 18263
services and county departments with the program.18264

       As part of their disability advocacy programs, the state 18265
department and county departments may enter into contracts for the 18266
services of persons and government entities that in the judgment 18267
of the department or county department have demonstrated expertise 18268
in representing persons seeking supplemental security income 18269
benefits. Each contract shall require the person or entity with 18270
which a department contracts to assess each person referred to it 18271
by the department to determine whether the person appears to be 18272
eligible for supplemental security income benefits, and, if the 18273
person appears to be eligible, assist the person in applying and 18274
represent the person in any proceeding of the social security18275
administration, including any appeal or reconsideration of a 18276
denial of benefits. The department or county department shall 18277
provide to the person or entity with which it contracts all 18278
records in its possession relevant to the application for 18279
supplemental security income benefits. The department shall 18280
require a county department with relevant records to submit them 18281
to the person or entity.18282

       (B) Each applicant for or recipient of disability financial 18283
assistance or disability medical assistance who, in the judgment 18284
of the department of job and family services or a county 18285
department of job and family services might be eligible for 18286
supplemental security benefits, shall, as a condition of 18287
eligibility for assistance, apply for such benefits if directed to 18288
do so by the department or county department.18289

       (C) With regard to applicants for and recipients of 18290
disability financial assistance or disability medical assistance, 18291
each county department of job and family services shall do all of 18292
the following:18293

       (1) Identify applicants and recipients who might be eligible 18294
for supplemental security income benefits;18295

       (2) Assist applicants and recipients in securing 18296
documentation of disabling conditions or refer them for such 18297
assistance to a person or government entity with which the18298
department or county department has contracted under division (A) 18299
of this section;18300

       (3) Inform applicants and recipients of available sources of 18301
representation, which may include a person or government entity 18302
with which the department or county department has contracted 18303
under division (A) of this section, and of their right to 18304
represent themselves in reconsiderations and appeals of social 18305
security administration decisions that deny them supplemental 18306
security income benefits. The county department may require the 18307
applicants and recipients, as a condition of eligibility for 18308
assistance, to pursue reconsiderations and appeals of social 18309
security administration decisions that deny them supplemental 18310
security income benefits, and shall assist applicants and 18311
recipients as necessary to obtain such benefits or refer them to a 18312
person or government entity with which the department or county 18313
department has contracted under division (A) of this section.18314

       (4) Require applicants and recipients who, in the judgment 18315
of the county department, are or may be aged, blind, or disabled, 18316
to apply for medical assistance under Chapter 5111. of the Revised 18317
Code, make determinations when appropriate as to eligibility for 18318
medical assistance, and refer their applications when necessary to 18319
the disability determination unit established in accordance with18320
division (F) of this section for expedited review;18321

       (5) Require each applicant and recipient who in the judgment 18322
of the department or the county department might be eligible for 18323
supplemental security income benefits, as a condition of 18324
eligibility for disability financial assistance or disability 18325
medical assistance, to execute a written authorization for the 18326
secretary of health and human services to withhold benefits due 18327
that individual and pay to the director of job and family services 18328
or the director's designee an amount sufficient to reimburse the 18329
state and county shares of interim assistance furnished to the 18330
individual. For the purposes of division (C)(5) of this section, 18331
"benefits" and "interim assistance" have the meanings given in 18332
Title XVI of the "Social Security Act."18333

       (D) The director of job and family services shall adopt rules 18334
in accordance with section 111.15 of the Revised Code for the 18335
effective administration of the disability advocacy program. The 18336
rules shall include all of the following:18337

       (1) Methods to be used in collecting information from and18338
disseminating it to county departments, including the following:18339

       (a) The number of individuals in the county who are disabled 18340
recipients of disability financial assistance or disability 18341
medical assistance;18342

       (b) The final decision made either by the social security18343
administration or by a court for each application or18344
reconsideration in which an individual was assisted pursuant to18345
this section.18346

       (2) The type and process of training to be provided by the18347
department of job and family services to the employees of the 18348
county department of job and family services who perform duties 18349
under this section and section 329.043 of the Revised Code;18350

       (3) Requirements for the written authorization required by18351
division (C)(5)(E) of this section 329.043 of the Revised Code.18352

       (E)(D) The department of job and family services shall 18353
provide basic and continuing training to employees of the county 18354
department of job and family services who perform duties under18355
this section and section 329.043 of the Revised Code. Training 18356
shall include but not be limited to all processes necessary to 18357
obtain federal disability benefits, and methods of advocacy.18358

       (F) The department shall establish a disability determination 18359
unit and develop guidelines for expediting reviews of applications 18360
for medical assistance under Chapter 5111. of the Revised Code for 18361
persons who have been referred to the unit under division (C)(4) 18362
of this section. The department shall make determinations of 18363
eligibility for medical assistance for any such person within the 18364
time prescribed by federal regulations.18365

       (G)(E) The department of job and family services may, under 18366
rules the director of job and family services adopts in accordance 18367
with section 111.15 of the Revised Code, pay a portion of the 18368
federal reimbursement described in division (C)(5)(E) of this18369
section 329.043 of the Revised Code to persons or government 18370
entities that assist or represent assistance recipients in 18371
reconsiderations and appeals of social security administration 18372
decisions denying them supplemental security income benefits.18373

       (H)(F) The director of job and family services shall conduct 18374
investigations to determine whether disability advocacy programs 18375
are being administered in compliance with the Revised Code and the 18376
rules adopted by the director pursuant to this section.18377

       Sec. 5115.22. (A) If a recipient of disability financial 18378
assistance or disability medical assistance, or an individual 18379
whose income and resources are included in determining the 18380
recipient's eligibility for the assistance, becomes possessed of 18381
resources or income in excess of the amount allowed to retain 18382
eligibility, or if other changes occur that affect the recipient's 18383
eligibility or need for assistance, the recipient shall notify the18384
state or county department of job and family services within the 18385
time limits specified in rules adopted by the director of job and 18386
family services in accordance with section 111.15 of the Revised 18387
Code. Failure of a recipient to report possession of excess 18388
resources or income or a change affecting eligibility or need 18389
within those time limits shall be considered prima-facie evidence 18390
of intent to defraud under section 5115.23 of the Revised Code.18391

       (B) As a condition of eligibility for disability financial 18392
assistance or disability medical assistance, and as a means of 18393
preventing or reducing the provision of assistance at public 18394
expense, each applicant for or recipient of the assistance shall 18395
make reasonable efforts to secure support from persons responsible 18396
for the applicant's or recipient's support, and from other 18397
sources, including any federal program designed to provide 18398
assistance to individuals with disabilities. The state or county 18399
department of job and family services may provide assistance to 18400
the applicant or recipient in securing other forms of financial 18401
assistance.18402

       Sec. 5115.23.  As used in this section, "erroneous payments" 18403
means disability financial assistance payments or disability 18404
medical assistance payments made to persons who are not entitled 18405
to receive them, including payments made as a result of 18406
misrepresentation or fraud, and payments made due to an error by 18407
the recipient or by the county department of job and family 18408
services that made the payment.18409

       The department of job and family services shall adopt rules 18410
in accordance with section 111.15 of the Revised Code specifying 18411
the circumstances under which action is to be taken under this 18412
section to recover erroneous payments. The department, or a county 18413
department of job and family services at the request of the18414
department, shall take action to recover erroneous payments in the 18415
circumstances specified in the rules. The department or county 18416
department may institute a civil action to recover erroneous 18417
payments.18418

       Whenever disability financial assistance or disability 18419
medical assistance has been furnished to a recipient for whose 18420
support another person is responsible, the other person shall, in 18421
addition to the liability otherwise imposed, as a consequence of 18422
failure to support the recipient, be liable for all assistance 18423
furnished the recipient. The value of the assistance so furnished 18424
may be recovered in a civil action brought by the county 18425
department of job and family services.18426

       Each county department of job and family services shall18427
retain fifty per cent of the erroneous payments it recovers under 18428
this section. The department of job and family services shall 18429
receive the remaining fifty per cent.18430

       Sec. 5117.10.  (A) On or before the fifteenth day of January, 18431
the director of development shall pay each applicant determined18432
eligible for a payment under divisions (A) and (B) of section18433
5117.07 of the Revised Code one hundred twenty-five dollars.18434

       (B) The director may withhold from any payment to which a18435
person would otherwise be entitled under division (A) of this18436
section any amount that the director determines was erroneously18437
received by such person in a preceding year under this or the18438
program established under Am. Sub. H.B. 230, as amended by Am.18439
H.B. 937, Am. Sub. H.B. 1073, Am. Sub. S.B. 493, and Am. Sub. S.B.18440
523 of the 112th general assembly, provided the director has18441
employed all other legal methods reasonably available to obtain18442
reimbursement for the erroneous payment or credit prior to the18443
commencement of the current program year.18444

       (C) Payments made under this section and credits granted18445
under section 5117.09 of the Revised Code shall not be considered18446
income for the purpose of determining eligibility or the level of18447
benefits or assistance under section 329.042 or Chapters 5107.,18448
5111., and 5115. of the Revised Code; the medicaid program; the 18449
disability medical assistance program; supplemental security 18450
income payments under Title XVI of the "Social Security Act," 49 18451
Stat. 620 (1935), 42 U.S.C. 301, as amended; or any other program 18452
under which eligibility or the level of benefits or assistance is 18453
based upon need measured by income.18454

       Sec. 5119.04.  The department of mental health and any18455
institutions under its supervision or jurisdiction shall, where18456
applicable, be in substantial compliance with standards set forth18457
for psychiatric facilities by the joint commission on18458
accreditation of healthcare organizations or medical assistance18459
medicaid standards under Title XIX of the "Social Security Act," 18460
49 Stat. 620 (1935), 42 U.S.C. 301, as amended, or other 18461
applicable standards, except that the department and any 18462
institution under its supervision or jurisdiction shall be in 18463
substantial compliance with standards for physical facilities and 18464
equipment by July 1, 1989. The requirements of this section do not 18465
apply to any facility designated by the director of mental health 18466
for use as a psychiatric rehabilitation center.18467

       The requirements of this section are in addition to any other 18468
requirements established by the Revised Code and nothing in this 18469
section shall be construed to limit any rights, privileges,18470
protections, or immunities which may exist under the constitution18471
and laws of the United States or this state.18472

       Sec. 5119.061.  (A) As used in this section, "mentally ill18473
individual" and "specialized services" have the same meanings as18474
in section 5111.2025119.061 of the Revised Code.18475

       (B)(1) Except as provided in division (B)(2) of this section 18476
and rules adopted under division (E)(3) of this section, for 18477
purposes of section 5111.2025119.061 of the Revised Code, the18478
department of mental health shall determine in accordance with18479
section 1919(e)(7) of the "Social Security Act," 49 Stat. 62018480
(1935), 42 U.S.C.A. 301, as amended,1396r(e)(7) and regulations 18481
adopted under section 1919(f)(8)(A) of that act42 U.S.C. 18482
1396r(f)(8)(A) whether, because of the individual's physical and 18483
mental condition, a mentally ill individual seeking admission to a 18484
nursing facility requires the level of services provided by a 18485
nursing facility and, if the individual requires that level of 18486
services, whether the individual requires specialized services for 18487
mental illness. The determination required by this division shall 18488
be based on an independent physical and mental evaluation 18489
performed by a person or entity other than the department.18490

       (2) A determination under this division is not required for 18491
any of the following:18492

       (a) An individual seeking readmission to a nursing facility 18493
after having been transferred from a nursing facility to a 18494
hospital for care;18495

       (b) An individual who meets all of the following conditions:18496

       (i) The individual is admitted to the nursing facility 18497
directly from a hospital after receiving inpatient care at the 18498
hospital;18499

       (ii) The individual requires nursing facility services for 18500
the condition for which care in the hospital was received;18501

       (iii) The individual's attending physician has certified,18502
before admission to the nursing facility, that the individual is 18503
likely to require less than thirty days of nursing facility 18504
services.18505

       (c) An individual transferred from one nursing facility to18506
another nursing facility, with or without an intervening hospital18507
stay.18508

       (C) Except as provided in rules adopted under division (F)(3) 18509
of this section, the department of mental health shall review and 18510
determine for each resident of a nursing facility who is mentally 18511
ill, whether the resident, because of the resident's physical and 18512
mental condition, requires the level of services provided by a 18513
nursing facility and whether the resident requires specialized 18514
services for mental illness. The review and determination shall be18515
conducted in accordance with section 1919(e)(7) of the "Social18516
Security Act" and the regulations adopted under section18517
1919(f)(8)(A) of the act and based on an independent physical and18518
mental evaluation performed by a person or entity other than the18519
department. The review and determination shall be completed 18520
promptly after a nursing facility has notified the department that 18521
there has been a significant change in the resident's mental or 18522
physical condition.18523

       (D)(1) In the case of a nursing facility resident who has18524
continuously resided in a nursing facility for at least thirty18525
months before the date of a review and determination under 18526
division (C) of this section, if the resident is determined not to 18527
require the level of services provided by a nursing facility, but 18528
is determined to require specialized services for mental illness,18529
the department, in consultation with the resident's family or18530
legal representative and care givers, shall do all of the 18531
following:18532

       (a) Inform the resident of the institutional and18533
noninstitutional alternatives covered under the state medicaid18534
plan for medical assistance;18535

       (b) Offer the resident the choice of remaining in the nursing 18536
facility or receiving covered services in an alternative18537
institutional or noninstitutional setting;18538

       (c) Clarify the effect on eligibility for services under the 18539
state medicaid plan for medical assistance if the resident chooses 18540
to leave the facility, including its effect on readmission to the18541
facility;18542

       (d) Provide for or arrange for the provision of specialized 18543
services for the resident's mental illness in the setting chosen 18544
by the resident.18545

       (2) In the case of a nursing facility resident who has18546
continuously resided in a nursing facility for less than thirty18547
months before the date of the review and determination under18548
division (C) of this section, if the resident is determined not to 18549
require the level of services provided by a nursing facility, but 18550
is determined to require specialized services for mental illness, 18551
or if the resident is determined to require neither the level of 18552
services provided by a nursing facility nor specialized services 18553
for mental illness, the department shall act in accordance with 18554
its alternative disposition plan approved by the United States18555
department of health and human services under section18556
1919(e)(7)(E) of the "Social Security Act."18557

       (3) In the case of an individual who is determined under18558
division (B) or (C) of this section to require both the level of18559
services provided by a nursing facility and specialized services18560
for mental illness, the department of mental health shall provide18561
or arrange for the provision of the specialized services needed by 18562
the individual or resident while residing in a nursing facility.18563

       (E) The department of mental health shall adopt rules in18564
accordance with Chapter 119. of the Revised Code that do all of18565
the following:18566

       (1) Establish criteria to be used in making the18567
determinations required by divisions (B) and (C) of this section.18568
The criteria shall not exceed the criteria established by18569
regulations adopted by the United States department of health and18570
human services under section 1919(f)(8)(A) of the "Social Security 18571
Act."18572

       (2) Specify information to be provided by the individual or 18573
nursing facility resident being assessed;18574

       (3) Specify any circumstances, in addition to circumstances 18575
listed in division (B) of this section, under which determinations 18576
under divisions (B) and (C) of this section are not required to be 18577
made.18578

       Sec. 5119.16.  As used in this section, "free clinic" has the 18579
same meaning as in section 2305.2341 of the Revised Code.18580

       (A) The department of mental health is hereby designated to 18581
provide certain goods and services for the department of mental 18582
health, the department of mental retardation and developmental 18583
disabilities, the department of rehabilitation and correction, the 18584
department of youth services, and other state, county, or 18585
municipal agencies requesting suchthose goods and services when 18586
the department of mental health determines that it is in the 18587
public interest, and considers it advisable, to provide these18588
those goods and services. The department of mental health also may 18589
provide goods and services to agencies operated by the United18590
States government and to public or private nonprofit agencies, 18591
other than free clinics, that are funded in whole or in part by 18592
the state if the public or private nonprofit agencies are 18593
designated for participation in this program by the director of 18594
mental health for community mental health agencies, the director 18595
of mental retardation and developmental disabilities for community 18596
mental retardation and developmental disabilities agencies, the 18597
director of rehabilitation and correction for community 18598
rehabilitation and correction agencies, or the director of youth 18599
services for community youth services agencies. 18600

       Designated community agencies shall receive goods and 18601
services through the department of mental health only in those 18602
cases where the designating state agency certifies that providing 18603
suchthe goods and services to the agency will conserve public 18604
resources to the benefit of the public and where the provision of 18605
suchthe goods and services is considered feasible by the 18606
department of mental health.18607

       (B) The department of mental health may permit free clinics 18608
to purchase certain goods and services to the extent the purchases 18609
fall within the exemption to the Robinson-Patman Act, 15 U.S.C. 13 18610
et seq., applicable to non-profitnonprofit institutions, in 15 18611
U.S.C. 13c, as amended.18612

       (C) The goods and services to be provided by the department 18613
of mental health under divisions (A) and (B) of this section may 18614
include all of the following:18615

       (1) Procurement, storage, processing, and distribution of18616
food and professional consultation on food operations;18617

       (2) Procurement, storage, and distribution of medical and18618
laboratory supplies, dental supplies, medical records, forms,18619
optical supplies, and sundries, subject to section 5120.135 of the 18620
Revised Code;18621

       (3) Procurement, storage, repackaging, distribution, and18622
dispensing of drugs, the provision of professional pharmacy18623
consultation, and drug information services;18624

       (4) Other goods and services as may be agreed to.18625

       (D) TheSubject to section 5160.75 of the Revised Code, the18626
department of mental health shall provide the goods and services 18627
designated in division (C) of this section to its institutions and 18628
to state-operated community-based mental health services.18629

       (E) After consultation with and advice from the director of 18630
mental retardation and developmental disabilities, the director of 18631
rehabilitation and correction, and the director of youth services 18632
and subject to section 5160.75 of the Revised Code, the department 18633
of mental health shall provide the goods and services designated 18634
in division (C) of this section to the department of mental 18635
retardation and developmental disabilities, the department of 18636
rehabilitation and correction, and the department of youth 18637
services.18638

       (F) The cost of administration of this section shall be18639
determined by the department of mental health and paid by the18640
agencies or free clinics receiving the goods and services to the 18641
department for deposit in the state treasury to the credit of the 18642
mental health fund, which is hereby created. The fund shall be 18643
used to pay the cost of administration of this section to the 18644
department.18645

       (G) If the goods or services designated in division (C) of18646
this section are not provided in a satisfactory manner by the18647
department of mental health to the agencies described in division 18648
(A) of this section, the director of mental retardation and 18649
developmental disabilities, the director of rehabilitation and 18650
correction, the director of youth services, or the managing18651
officer of a department of mental health institution shall attempt 18652
to resolve unsatisfactory service with the director of mental 18653
health. If, after suchthe attempt, the provision of goods or18654
services continues to be unsatisfactory, the director or officer18655
shall notify the director of mental health. If, within thirty days 18656
of suchthat notice the department of mental health does not18657
provide the specified goods and services in a satisfactory manner, 18658
the director of mental retardation and developmental disabilities, 18659
the director of rehabilitation and correction, the director of 18660
youth services, or the managing officer of the department of 18661
mental health institution shall notify the director of mental 18662
health of the director's or managing officer's intent to cease 18663
purchasing goods and services from the department. Following a18664
sixty-day cancellation period from the date of suchthat notice 18665
and subject to section 5160.75 of the Revised Code, the department 18666
of mental retardation, department of rehabilitation and 18667
correction, department of youth services, or the department of 18668
mental health institution may obtain the goods and services from a 18669
source other than the department of mental health, if the 18670
department certifies to the department of administrative services 18671
that the requirements of this division have been met.18672

       (H) Whenever a state agency fails to make a payment for goods 18673
and services provided under this section within thirty-one days 18674
after the date the payment was due, the office of budget and18675
management may transfer moneys from the state agency to the18676
department of mental health. The amount transferred shall not18677
exceed the amount of overdue payments. Prior to making a transfer 18678
under this division, the office of budget and management shall 18679
apply any credits the state agency has accumulated in payments for 18680
goods and services provided under this section.18681

       (I) Purchases of goods and services under this section are 18682
not subject to section 307.86 of the Revised Code.18683

       (J) The department shall not perform any acts described in 18684
division (A)(3) of this section for state departments or other 18685
state agencies covered by the operation of section 5160.75 of the 18686
Revised Code.18687

       Sec. 5119.351.  The department of mental health may pay an 18688
amount for personal use to each individual residing in a state 18689
institution as described in section 5119.02 of the Revised Code 18690
who would be eligible for supplemental security income benefits at 18691
the reduced rate established by Title XVI of the "Social Security 18692
Act," 49 Stat. 620 (1935), 42 U.S.C.A. 1382, as amendedthe 18693
supplemental security income program, if the state medicaid plan 18694
for providing medical assistance under section 5111.01 of the 18695
Revised Code included reimbursement of services provided in such 18696
institutions. The amount paid by the department shall not exceed 18697
the reduced supplemental security income benefit rate established 18698
by Title XVI of the "Social Security Actthe program."18699

       Sec. 5119.61.  Any provision in this chapter that refers to a18700
board of alcohol, drug addiction, and mental health services also18701
refers to the community mental health board in an alcohol, drug18702
addiction, and mental health service district that has a community18703
mental health board.18704

       The director of mental health with respect to all facilities18705
and programs established and operated under Chapter 340. of the18706
Revised Code for mentally ill and emotionally disturbed persons,18707
shall do all of the following:18708

       (A) Adopt rules pursuant to Chapter 119. of the Revised Code18709
that may be necessary to carry out the purposes of Chapter 340.18710
and sections 5119.61 to 5119.63 of the Revised Code.18711

       (1) The rules shall include all of the following:18712

       (a) Rules governing a community mental health agency's18713
services under section 340.091 of the Revised Code to an18714
individual referred to the agency under division (C)(2) of section18715
173.355160.80 of the Revised Code;18716

       (b) For the purpose of division (A)(16) of section 340.03 of18717
the Revised Code, rules governing the duties of mental health18718
agencies and boards of alcohol, drug addiction, and mental health18719
services under section 3722.18 of the Revised Code regarding18720
referrals of individuals with mental illness or severe mental18721
disability to adult care facilities and effective arrangements for18722
ongoing mental health services for the individuals. The rules18723
shall do at least the following:18724

       (i) Provide for agencies and boards to participate fully in18725
the procedures owners and managers of adult care facilities must18726
follow under division (A)(2) of section 3722.18 of the Revised18727
Code;18728

       (ii) Specify the manner in which boards are accountable for18729
ensuring that ongoing mental health services are effectively18730
arranged for individuals with mental illness or severe mental18731
disability who are referred by the board or mental health agency18732
under contract with the board to an adult care facility.18733

       (c) Rules governing a board of alcohol, drug addiction, and18734
mental health services when making a report to the director of18735
health under section 3722.17 of the Revised Code regarding the18736
quality of care and services provided by an adult care facility to18737
a person with mental illness or a severe mental disability.18738

       (2) Rules may be adopted to govern the method of paying a18739
community mental health facility, as defined in section 5111.02318740
5163.20 of the Revised Code, for providing services listed in 18741
division (B) of that section. Such rules must be consistent with 18742
the contract entered into between the departments of job and 18743
family serviceshealth care administration and mental health under 18744
section 5111.915161.05 of the Revised Code and include 18745
requirements ensuring appropriate service utilization.18746

       (B) Review and evaluate, and, taking into account the18747
findings and recommendations of the board of alcohol, drug18748
addiction, and mental health services of the district served by18749
the program and the requirements and priorities of the state18750
mental health plan, including the needs of residents of the18751
district now residing in state mental institutions, approve and18752
allocate funds to support community programs, and make18753
recommendations for needed improvements to boards of alcohol, drug18754
addiction, and mental health services;18755

       (C) Withhold state and federal funds for any program, in18756
whole or in part, from a board of alcohol, drug addiction, and18757
mental health services in the event of failure of that program to18758
comply with Chapter 340. or section 5119.61, 5119.611, 5119.612,18759
or 5119.62 of the Revised Code or rules of the department of18760
mental health. The director shall identify the areas of18761
noncompliance and the action necessary to achieve compliance. The18762
director shall offer technical assistance to the board to achieve18763
compliance. The director shall give the board a reasonable time18764
within which to comply or to present its position that it is in18765
compliance. Before withholding funds, a hearing shall be conducted18766
to determine if there are continuing violations and that either18767
assistance is rejected or the board is unable to achieve18768
compliance. Subsequent to the hearing process, if it is determined 18769
that compliance has not been achieved, the director may allocate 18770
all or part of the withheld funds to a public or private agency to 18771
provide the services not in compliance until the time that there 18772
is compliance. The director shall establish rules pursuant to 18773
Chapter 119. of the Revised Code to implement this division.18774

       (D) Withhold state or federal funds from a board of alcohol,18775
drug addiction, and mental health services that denies available18776
service on the basis of religion, race, color, creed, sex,18777
national origin, age, disability as defined in section 4112.01 of18778
the Revised Code, developmental disability, or the inability to18779
pay;18780

       (E) Provide consultative services to community mental health 18781
agencies with the knowledge and cooperation of the board of18782
alcohol, drug addiction, and mental health services;18783

       (F) Provide to boards of alcohol, drug addiction, and mental18784
health services state or federal funds, in addition to those18785
allocated under section 5119.62 of the Revised Code, for special18786
programs or projects the director considers necessary but for18787
which local funds are not available;18788

       (G) Establish criteria by which a board of alcohol, drug18789
addiction, and mental health services reviews and evaluates the18790
quality, effectiveness, and efficiency of services provided18791
through its community mental health plan. The criteria shall18792
include requirements ensuring appropriate service utilization. The18793
department shall assess a board's evaluation of services and the18794
compliance of each board with this section, Chapter 340. or18795
section 5119.62 of the Revised Code, and other state or federal18796
law and regulations. The department, in cooperation with the18797
board, periodically shall review and evaluate the quality,18798
effectiveness, and efficiency of services provided through each18799
board. The department shall collect information that is necessary18800
to perform these functions.18801

       (H) Develop and operate a community mental health information 18802
system.18803

       Boards of alcohol, drug abuse, and mental health services18804
shall submit information requested by the department in the form18805
and manner prescribed by the department. Information collected by18806
the department shall include, but not be limited to, all of the18807
following:18808

       (1) Information regarding units of services provided in whole 18809
or in part under contract with a board, including diagnosis and 18810
special needs, demographic information, the number of units of18811
service provided, past treatment, financial status, and service18812
dates in accordance with rules adopted by the department in18813
accordance with Chapter 119. of the Revised Code;18814

       (2) Financial information other than price or price-related18815
data regarding expenditures of boards and community mental health18816
agencies, including units of service provided, budgeted and actual18817
expenses by type, and sources of funds.18818

       Boards shall submit the information specified in division18819
(H)(1) of this section no less frequently than annually for each18820
client, and each time the client's case is opened or closed. The18821
department shall not collect any information for the purpose of18822
identifying by name any person who receives a service through a18823
board of alcohol, drug addiction, and mental health services,18824
except as required by state or federal law to validate appropriate18825
reimbursement. For the purposes of division (H)(1) of this18826
section, the department shall use an identification system that is18827
consistent with applicable nationally recognized standards.18828

       (I) Review each board's community mental health plan18829
submitted pursuant to section 340.03 of the Revised Code and18830
approve or disapprove it in whole or in part. Periodically, in18831
consultation with representatives of boards and after considering18832
the recommendations of the medical director, the director shall18833
issue criteria for determining when a plan is complete, criteria18834
for plan approval or disapproval, and provisions for conditional18835
approval. The factors that the director considers may include, but 18836
are not limited to, the following:18837

       (1) The mental health needs of all persons residing within18838
the board's service district, especially severely mentally18839
disabled children, adolescents, and adults;18840

       (2) The demonstrated quality, effectiveness, efficiency, and18841
cultural relevance of the services provided in each service18842
district, the extent to which any services are duplicative of18843
other available services, and whether the services meet the needs18844
identified above;18845

       (3) The adequacy of the board's accounting for the18846
expenditure of funds.18847

       If the director disapproves all or part of any plan, the18848
director shall provide the board an opportunity to present its18849
position. The director shall inform the board of the reasons for18850
the disapproval and of the criteria that must be met before the18851
plan may be approved. The director shall give the board a18852
reasonable time within which to meet the criteria, and shall offer18853
technical assistance to the board to help it meet the criteria.18854

       If the approval of a plan remains in dispute thirty days18855
prior to the conclusion of the fiscal year in which the board's18856
current plan is scheduled to expire, the board or the director may18857
request that the dispute be submitted to a mutually agreed upon18858
third-party mediator with the cost to be shared by the board and18859
the department. The mediator shall issue to the board and the18860
department recommendations for resolution of the dispute. Prior to18861
the conclusion of the fiscal year in which the current plan is18862
scheduled to expire, the director, taking into consideration the18863
recommendations of the mediator, shall make a final determination18864
and approve or disapprove the plan, in whole or in part.18865

       Sec. 5120.65.  (A) The department of rehabilitation and 18866
correction may establish in one or more of the institutions for 18867
women operated by the department a prison nursery program under 18868
which eligible inmates and children born to them while in the 18869
custody of the department may reside together in the institution. 18870
If the department establishes a prison nursery program in one or 18871
more institutions under this section, sections 5120.651 to 18872
5120.657 of the Revised Code apply regarding the program. If the 18873
department establishes a prison nursery program and an inmate 18874
participates in the program, neither the inmate's participation in 18875
the program nor any provision of sections 5120.65 to 5120.657 of 18876
the Revised Code affects, modifies, or interferes with the 18877
inmate's custodial rights of the child or establishes legal 18878
custody of the child with the department.18879

       (B) As used in sections 5120.651 to 5120.657 of the Revised 18880
Code:18881

       (1) "Prison nursery program" means the prison nursery program 18882
established by the department of rehabilitation and correction 18883
under this section, if one is so established.18884

       (2) "Public assistance" has the same meaning as in section 18885
5101.58 of the Revised Codemeans all of the following:18886

       (a) Medicaid;18887

       (b) Disability medical assistance;18888

       (c) The Ohio works first program established under Chapter 18889
5107. of the Revised Code;18890

       (d) Disability financial assistance established under Chapter 18891
5115. of the Revised Code.18892

       (3) "Support" means amounts to be paid under a support order.18893

       (4) "Support order" has the same meaning as in section 18894
3119.01 of the Revised Code.18895

       Sec. 5120.652.  To participate in the prison nursery program, 18896
each eligible inmate selected by the department shall do all the 18897
following:18898

       (A) Agree in writing to do all the following:18899

       (1) Comply with any program, educational, counseling, and 18900
other requirements established for the program by the department 18901
of rehabilitation and correction;18902

       (2) If eligible, have the child participate in the medicaid 18903
program or a health insurance program;18904

       (3) Accept the normal risks of childrearing;18905

       (4) Abide by any court decisions regarding the allocation of 18906
parental rights and responsibilities with respect to the child.18907

       (B) Assign to the department any rights to support from any 18908
other person, excluding support assigned pursuant to section 18909
5107.20 of the Revised Code and medical support assigned pursuant 18910
to section 5101.595160.37 of the Revised Code;18911

       (C) Specify with whom the child is to be placed in the event 18912
the inmate's participation in the program is terminated for a 18913
reason other than release from imprisonment.18914

       Sec. 5121.04.  (A) The department of mental retardation and 18915
developmental disabilities shall investigate the financial 18916
condition of the residents in institutions, residents whose care 18917
or treatment is being paid for in a private facility or home under18918
the control of the department, and of the relatives named in 18919
section 5121.06 of the Revised Code as liable for the support of 18920
such residents, in order to determine the ability of any resident 18921
or liable relatives to pay for the support of the resident and to 18922
provide suitable clothing as required by the superintendent of the 18923
institution.18924

       (B) The department shall follow the provisions of this18925
division in determining the ability to pay of a resident or the 18926
resident's liable relatives and the amount to be charged such 18927
resident or liable relatives.18928

       (1) Subject to divisions (B)(10) and (11) of this section, a 18929
resident without dependents shall be liable for the full 18930
applicable cost. A resident without dependents who has a gross 18931
annual income equal to or exceeding the sum of the full applicable18932
cost, plus fifty dollars per month, regardless of the source of18933
such income, shall pay currently the full amount of the applicable 18934
cost; if the resident's gross annual income is less than such sum,18935
not more than fifty dollars per month shall be kept for personal18936
use by or on behalf of the resident, except as permitted in the 18937
state medicaid plan for providing medical assistance under Title 18938
XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 18939
301, as amended, and the balance shall be paid currently on the 18940
resident's support. Subject to divisions (B)(10) and (11) of this18941
section, the estate of a resident without dependents shall pay18942
currently any remaining difference between the applicable cost and18943
the amounts prescribed in this section, or shall execute an18944
agreement with the department for payment to be made at some18945
future date under terms suitable to the department. However, no18946
security interest, mortgage, or lien shall be taken, granted, or18947
charged against any principal residence of a resident without 18948
dependents under an agreement or otherwise to secure support 18949
payments, and no foreclosure actions shall be taken on security 18950
interests, mortgages, or liens taken, granted, or charged against 18951
principal residences of residents prior to October 7, 1977.18952

       (2) The ability to pay of a resident with dependents, or of a 18953
liable relative of a resident either with or without dependents, 18954
shall be determined in accordance with the resident's or liable18955
relative's income or other assets, the needs of others who are 18956
dependent on such income and other assets for support, and, if 18957
applicable, divisions (B)(10) and (11) of this section.18958

       For the first thirty days of care and treatment of each18959
admission, but in no event for more than thirty days in any18960
calendar year, the resident with dependents or the liable 18961
relative of a resident either with or without dependents shall be 18962
charged an amount equal to the percentage of the average 18963
applicable cost determined in accordance with the schedule of 18964
adjusted gross annual income contained after this paragraph. After 18965
such first thirty days of care and treatment, such resident or 18966
such liable relative shall be charged an amount equal to the18967
percentage of a base support rate of four dollars per day for 18968
residents, as determined in accordance with the schedule of gross 18969
annual income contained after this paragraph, or in accordance 18970
with division (B)(5) of this section. Beginning January 1, 1978, 18971
the department shall increase the base rate when the consumer 18972
price index average is more than 4.0 for the preceding calendar 18973
year by not more than the average for such calendar year.18974

Adjusted Gross Annual 18975
Income of Resident 18976
or Liable Relative (FN a) Number of Dependents (FN b) 18977

8 or 18978
1 2 3 4 5 6 7 more 18979
Rate of Support (In Percentages) 18980
$15,000 or less -- -- -- -- -- -- -- -- 18981
15,001 to 17,500 20 -- -- -- -- -- -- -- 18982
17,501 to 20,000 25 20 -- -- -- -- -- -- 18983
20,001 to 21,000 30 25 20 -- -- -- -- -- 18984
21,001 to 22,000 35 30 25 20 -- -- -- -- 18985
22,001 to 23,000 40 35 30 25 20 -- -- -- 18986
23,001 to 24,000 45 40 35 30 25 20 -- -- 18987
24,001 to 25,000 50 45 40 35 30 25 20 -- 18988
25,001 to 26,000 55 50 45 40 35 30 25 20 18989
26,001 to 27,000 60 55 50 45 40 35 30 25 18990
27,001 to 28,000 70 60 55 50 45 40 35 30 18991
28,001 to 30,000 80 70 60 55 50 45 40 35 18992
30,001 to 40,000 90 80 70 60 55 50 45 40 18993
40,001 and over 100 90 80 70 60 55 50 45 18994

       Footnote a. The resident or relative shall furnish a copy of 18995
the resident's or relative's federal income tax return as evidence 18996
of gross annual income.18997

       Footnote b. The number of dependents includes the liable18998
relative but excludes a resident in an institution. "Dependent" 18999
includes any person who receives more than half the person's 19000
support from the resident or the resident's liable relative.19001

       (3) A resident or liable relative having medical, funeral, or 19002
related expenses in excess of four per cent of the adjusted gross 19003
annual income, which expenses were not covered by insurance, may 19004
adjust such gross annual income by reducing the adjusted gross 19005
annual income by the full amount of such expenses. Proof of such 19006
expenses satisfactory to the department must be furnished.19007

       (4) Additional dependencies may be claimed if:19008

       (a) The liable relative is blind;19009

       (b) The liable relative is over sixty-five;19010

       (c) A child is a college student with expenses in excess of19011
fifty dollars per month;19012

       (d) The services of a housekeeper, costing in excess of fifty 19013
dollars per month, are required if the person who normally keeps 19014
house for minor children is the resident.19015

       (5) If with respect to any resident with dependents there is 19016
chargeable under division (B)(2) of this section less than fifty 19017
per cent of the applicable cost or, if the base support rate was 19018
used, less than fifty per cent of the amount determined by use of 19019
the base support rate, and if with respect to such resident there 19020
is a liable relative who has an estate having a value in excess of 19021
fifteen thousand dollars or if such resident has a dependent and 19022
an estate having a value in excess of fifteen thousand dollars,19023
there shall be paid with respect to such resident a total of fifty 19024
per cent of the applicable cost or the base support rate amount, 19025
as the case may be, on a current basis or there shall be executed 19026
with respect to such resident an agreement with the department for 19027
payment to be made at some future date under terms suitable to the 19028
department.19029

       (6) When a person has been a resident for fifteen years and 19030
the support charges for which a relative is liable have been paid 19031
for the fifteen-year period, the liable relative shall be relieved 19032
of any further support charges.19033

       (7) The department shall accept voluntary payments from 19034
residents or liable relatives whose incomes are below the minimum 19035
shown in the schedule set forth in this division. The department 19036
also shall accept voluntary payments in excess of required amounts 19037
from both liable and nonliable relatives.19038

       (8) If a resident is covered by an insurance policy, or other 19039
contract that provides for payment of expenses for care and 19040
treatment for mental retardation or other developmental disability19041
at or from an institution or facility (including a community19042
service unit under the jurisdiction of the department), the other19043
provisions of this section, except divisions (B)(8), (10), and19044
(11) of this section, and of section 5121.01 of the Revised Code19045
shall be suspended to the extent that such insurance policy or19046
other contract is in force, and such resident shall be charged the 19047
full amount of the applicable cost. Any insurance carrier or other 19048
third party payor providing coverage for such care and treatment 19049
shall pay for this support obligation in an amount equal to the 19050
lesser of either the applicable cost or the benefits provided 19051
under the policy or other contract. Whether or not an insured, 19052
owner of, or other person having an interest in such policy or 19053
other contract is liable for support payments under other 19054
provisions of this chapter, the insured, policy owner, or other 19055
person shall assign payment directly to the department of all 19056
assignable benefits under the policy or other contract and shall 19057
pay over to the department, within ten days of receipt, all19058
insurance or other benefits received as reimbursement or payment19059
for expenses incurred by the resident or for any other reason. If 19060
the insured, policy owner, or other person refuses to assign such 19061
payment to the department or refuses to pay such received 19062
reimbursements or payments over to the department within ten days 19063
of receipt, the insured's, policy owners', or other person's total 19064
liability for the services equals the applicable statutory 19065
liability for payment for the services as determined under other 19066
provisions of this chapter, plus the amounts payable under the 19067
terms of the policy or other contract. In no event shall this 19068
total liability exceed the full amount of the applicable cost. 19069
Upon its request, the department is entitled to a court order that 19070
compels the insured, owner of, or other person having an interest 19071
in the policy or other contract to comply with the assignment 19072
requirements of this division or that itself serves as a legally 19073
sufficient assignment in compliance with such requirements. 19074
Notwithstanding section 5123.89 of the Revised Code and any other 19075
law relating to confidentiality of records, the managing officer 19076
of the institution or facility where a person is or has been a 19077
resident shall disclose pertinent medical information concerning 19078
the resident to the insurance carrier or other third party payor 19079
in question, in order to effect collection from the carrier or 19080
payor of the state's claim for care and treatment under this 19081
division. For such disclosure, the managing officer is not subject 19082
to any civil or criminal liability.19083

       (9) The rate to be charged for pre-admission care,19084
after-care, day-care, or routine consultation and treatment19085
services shall be based upon the ability of the resident or the 19086
resident's liable relatives to pay. When it is determined by the 19087
department that a charge shall be made, such charge shall be 19088
computed as provided in divisions (B)(1) and (2) of this section.19089

       (10) If a resident with or without dependents is the 19090
beneficiary of a trust created pursuant to section 1339.51 of the 19091
Revised Code, then, notwithstanding any contrary provision of this 19092
chapter or of a rule adopted pursuant to this chapter, divisions 19093
(C) and (D) of that section shall apply in determining the assets 19094
or resources of the resident, the resident's estate, the settlor,19095
or the settlor's estate and to claims arising under this chapter19096
against the resident, the resident's estate, the settlor, or the 19097
settlor's estate.19098

       (11) If the department waives the liability of an individual19099
and the individual's liable relatives pursuant to section 5123.19419100
of the Revised Code, the liability of the individual and relative19101
ceases in accordance with the waiver's terms.19102

       (C) The department may enter into agreements with a resident 19103
or a liable relative for support payments to be made in the 19104
future. However, no security interest, mortgage, or lien shall be 19105
taken, granted, or charged against any principal family residence 19106
of a resident with dependents or a liable relative under an 19107
agreement or otherwise to secure support payments, and no 19108
foreclosure actions shall be taken on security interests, 19109
mortgages or liens taken, granted, or charged against principal 19110
residences of residents or liable relatives prior to October 7, 19111
1977.19112

       (D) The department shall make all investigations and19113
determinations required by this section within ninety days after a 19114
resident is admitted to an institution under the department's 19115
control and immediately shall notify by mail the persons liable of 19116
the amount to be charged.19117

       (E) All actions to enforce the collection of payments agreed19118
upon or charged by the department shall be commenced within six19119
years after the date of default of an agreement to pay support19120
charges or the date such payment becomes delinquent. If a payment19121
is made pursuant to an agreement which is in default, a new19122
six-year period for actions to enforce the collection of payments19123
under such agreement shall be computed from the date of such19124
payment. For purposes of this division an agreement is in default19125
or a payment is delinquent if a payment is not made within thirty19126
days after it is incurred or a payment, pursuant to an agreement,19127
is not made within thirty days after the date specified for such19128
payment. In all actions to enforce the collection of payment for19129
the liability for support, every court of record shall receive19130
into evidence the proof of claim made by the state together with19131
all debts and credits, and it shall be prima-facie evidence of the19132
facts contained in it.19133

       Sec. 5123.01.  As used in this chapter:19134

       (A) "Chief medical officer" means the licensed physician19135
appointed by the managing officer of an institution for the19136
mentally retarded with the approval of the director of mental19137
retardation and developmental disabilities to provide medical19138
treatment for residents of the institution.19139

       (B) "Chief program director" means a person with special19140
training and experience in the diagnosis and management of the19141
mentally retarded, certified according to division (C) of this19142
section in at least one of the designated fields, and appointed by19143
the managing officer of an institution for the mentally retarded19144
with the approval of the director to provide habilitation and care19145
for residents of the institution.19146

       (C) "Comprehensive evaluation" means a study, including a19147
sequence of observations and examinations, of a person leading to19148
conclusions and recommendations formulated jointly, with19149
dissenting opinions if any, by a group of persons with special19150
training and experience in the diagnosis and management of persons19151
with mental retardation or a developmental disability, which group19152
shall include individuals who are professionally qualified in the19153
fields of medicine, psychology, and social work, together with19154
such other specialists as the individual case may require.19155

       (D) "Education" means the process of formal training and19156
instruction to facilitate the intellectual and emotional19157
development of residents.19158

       (E) "Habilitation" means the process by which the staff of19159
the institution assists the resident in acquiring and maintaining19160
those life skills that enable the resident to cope more19161
effectively with the demands of the resident's own person and of19162
the resident's environment and in raising the level of the19163
resident's physical, mental, social, and vocational efficiency.19164
Habilitation includes but is not limited to programs of formal,19165
structured education and training.19166

       (F) "Health officer" means any public health physician,19167
public health nurse, or other person authorized or designated by a19168
city or general health district.19169

       (G) "Home and community-based services" means medicaid-funded 19170
home and community-based services specified in division (B)(1) of 19171
section 5111.875163.65 of the Revised Code provided under the19172
medicaid waiver components the department of mental retardation 19173
and developmental disabilities administers pursuant to section19174
5111.8715163.651 of the Revised Code.19175

       (H) "Indigent person" means a person who is unable, without19176
substantial financial hardship, to provide for the payment of an19177
attorney and for other necessary expenses of legal representation,19178
including expert testimony.19179

       (I) "Institution" means a public or private facility, or a19180
part of a public or private facility, that is licensed by the19181
appropriate state department and is equipped to provide19182
residential habilitation, care, and treatment for the mentally19183
retarded.19184

       (J) "Licensed physician" means a person who holds a valid19185
certificate issued under Chapter 4731. of the Revised Code19186
authorizing the person to practice medicine and surgery or19187
osteopathic medicine and surgery, or a medical officer of the19188
government of the United States while in the performance of the19189
officer's official duties.19190

       (K) "Managing officer" means a person who is appointed by the19191
director of mental retardation and developmental disabilities to19192
be in executive control of an institution for the mentally19193
retarded under the jurisdiction of the department.19194

       (L) "Medicaid" has the same meaning as in section 5111.01 of19195
the Revised Code.19196

       (M) "Medicaid case management services" means case management 19197
services provided to an individual with mental retardation or 19198
other developmental disability that the state medicaid plan 19199
requires.19200

       (N)(M) "Mentally retarded person" means a person having19201
significantly subaverage general intellectual functioning existing19202
concurrently with deficiencies in adaptive behavior, manifested19203
during the developmental period.19204

       (O)(N) "Mentally retarded person subject to19205
institutionalization by court order" means a person eighteen years19206
of age or older who is at least moderately mentally retarded and19207
in relation to whom, because of the person's retardation, either19208
of the following conditions exist:19209

       (1) The person represents a very substantial risk of physical 19210
impairment or injury to self as manifested by evidence that the 19211
person is unable to provide for and is not providing for the 19212
person's most basic physical needs and that provision for those19213
needs is not available in the community;19214

       (2) The person needs and is susceptible to significant19215
habilitation in an institution.19216

       (P)(O) "A person who is at least moderately mentally19217
retarded" means a person who is found, following a comprehensive19218
evaluation, to be impaired in adaptive behavior to a moderate19219
degree and to be functioning at the moderate level of intellectual19220
functioning in accordance with standard measurements as recorded19221
in the most current revision of the manual of terminology and19222
classification in mental retardation published by the American19223
association on mental retardation.19224

       (Q)(P) As used in this division, "substantial functional19225
limitation," "developmental delay," and "established risk" have19226
the meanings established pursuant to section 5123.011 of the19227
Revised Code.19228

       "Developmental disability" means a severe, chronic disability19229
that is characterized by all of the following:19230

       (1) It is attributable to a mental or physical impairment or19231
a combination of mental and physical impairments, other than a19232
mental or physical impairment solely caused by mental illness as19233
defined in division (A) of section 5122.01 of the Revised Code.19234

       (2) It is manifested before age twenty-two.19235

       (3) It is likely to continue indefinitely.19236

       (4) It results in one of the following:19237

       (a) In the case of a person under three years of age, at19238
least one developmental delay or an established risk;19239

       (b) In the case of a person at least three years of age but19240
under six years of age, at least two developmental delays or an19241
established risk;19242

       (c) In the case of a person six years of age or older, a19243
substantial functional limitation in at least three of the19244
following areas of major life activity, as appropriate for the19245
person's age: self-care, receptive and expressive language,19246
learning, mobility, self-direction, capacity for independent19247
living, and, if the person is at least sixteen years of age,19248
capacity for economic self-sufficiency.19249

       (5) It causes the person to need a combination and sequence19250
of special, interdisciplinary, or other type of care, treatment,19251
or provision of services for an extended period of time that is19252
individually planned and coordinated for the person.19253

       (R)(Q) "Developmentally disabled person" means a person with19254
a developmental disability.19255

       (S)(R) "State institution" means an institution that is19256
tax-supported and under the jurisdiction of the department.19257

       (T)(S) "Residence" and "legal residence" have the same19258
meaning as "legal settlement," which is acquired by residing in19259
Ohio for a period of one year without receiving general assistance19260
prior to July 17, 1995, under former Chapter 5113. of the Revised19261
Code, financial assistance under Chapter 5115. of the Revised19262
Code, or assistance from a private agency that maintains records19263
of assistance given. A person having a legal settlement in the19264
state shall be considered as having legal settlement in the19265
assistance area in which the person resides. No adult person19266
coming into this state and having a spouse or minor children19267
residing in another state shall obtain a legal settlement in this19268
state as long as the spouse or minor children are receiving 19269
public assistance, care, or support at the expense of the other 19270
state or its subdivisions. For the purpose of determining the 19271
legal settlement of a person who is living in a public or private19272
institution or in a home subject to licensing by the department 19273
of job and family services, the department of mental health, or 19274
the department of mental retardation and developmental 19275
disabilities, the residence of the person shall be considered as 19276
though the person were residing in the county in which the person 19277
was living prior to the person's entrance into the institution or19278
home. Settlement once acquired shall continue until a person has 19279
been continuously absent from Ohio for a period of one year or 19280
has acquired a legal residence in another state. A woman who19281
marries a man with legal settlement in any county immediately 19282
acquires the settlement of her husband. The legal settlement of a 19283
minor is that of the parents, surviving parent, sole parent, 19284
parent who is designated the residential parent and legal 19285
custodian by a court, other adult having permanent custody 19286
awarded by a court, or guardian of the person of the minor, 19287
provided that:19288

       (1) A minor female who marries shall be considered to have19289
the legal settlement of her husband and, in the case of death of19290
her husband or divorce, she shall not thereby lose her legal19291
settlement obtained by the marriage.19292

       (2) A minor male who marries, establishes a home, and who has 19293
resided in this state for one year without receiving general19294
assistance prior to July 17, 1995, under former Chapter 5113. of19295
the Revised Code, financial assistance under Chapter 5115. of the19296
Revised Code, or assistance from a private agency that maintains19297
records of assistance given shall be considered to have obtained a19298
legal settlement in this state.19299

       (3) The legal settlement of a child under eighteen years of19300
age who is in the care or custody of a public or private child19301
caring agency shall not change if the legal settlement of the19302
parent changes until after the child has been in the home of the19303
parent for a period of one year.19304

       No person, adult or minor, may establish a legal settlement19305
in this state for the purpose of gaining admission to any state19306
institution.19307

       (U)(T)(1) "Resident" means, subject to division (R)(2) of19308
this section, a person who is admitted either voluntarily or19309
involuntarily to an institution or other facility pursuant to19310
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised19311
Code subsequent to a finding of not guilty by reason of insanity19312
or incompetence to stand trial or under this chapter who is under19313
observation or receiving habilitation and care in an institution.19314

       (2) "Resident" does not include a person admitted to an19315
institution or other facility under section 2945.39, 2945.40,19316
2945.401, or 2945.402 of the Revised Code to the extent that the19317
reference in this chapter to resident, or the context in which the19318
reference occurs, is in conflict with any provision of sections19319
2945.37 to 2945.402 of the Revised Code.19320

       (V)(U) "Respondent" means the person whose detention,19321
commitment, or continued commitment is being sought in any19322
proceeding under this chapter.19323

       (W)(V) "Working day" and "court day" mean Monday, Tuesday,19324
Wednesday, Thursday, and Friday, except when such day is a legal19325
holiday.19326

       (X)(W) "Prosecutor" means the prosecuting attorney, village19327
solicitor, city director of law, or similar chief legal officer19328
who prosecuted a criminal case in which a person was found not19329
guilty by reason of insanity, who would have had the authority to19330
prosecute a criminal case against a person if the person had not19331
been found incompetent to stand trial, or who prosecuted a case in19332
which a person was found guilty.19333

       (Y)(X) "Court" means the probate division of the court of19334
common pleas.19335

       (Z)(Y) "Supported living" has the same meaning as in section 19336
5126.01 of the Revised Code.19337

       Sec. 5123.021.  (A) As used in this section, "mentally19338
retarded individual" and "specialized services" have the same19339
meanings as in section 5111.2025164.45 of the Revised Code.19340

       (B)(1) Except as provided in division (B)(2) of this section 19341
and rules adopted under division (E)(3) of this section, for 19342
purposes of section 5111.2025164.41 of the Revised Code, the19343
department of mental retardation and developmental disabilities19344
shall determine in accordance with section 1919(e)(7) of the19345
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as19346
amended,1396r(e)(7) and regulations adopted under section 19347
1919(f)(8)(A) of that act42 U.S.C. 1396r(f)(8)(A) whether, 19348
because of the individual's physical and mental condition, a19349
mentally retarded individual seeking admission to a nursing19350
facility requires the level of services provided by a nursing19351
facility and, if the individual requires that level of services,19352
whether the individual requires specialized services for mental19353
retardation.19354

       (2) A determination under this division is not required for 19355
any of the following:19356

       (a) An individual seeking readmission to a nursing facility 19357
after having been transferred from a nursing facility to a 19358
hospital for care;19359

       (b) An individual who meets all of the following conditions:19360

       (i) The individual is admitted to the nursing facility 19361
directly from a hospital after receiving inpatient care at the 19362
hospital;19363

       (ii) The individual requires nursing facility services for 19364
the condition for which the individual received care in the19365
hospital;19366

       (iii) The individual's attending physician has certified, 19367
before admission to the nursing facility, that the individual is 19368
likely to require less than thirty days of nursing facility 19369
services.19370

       (c) An individual transferred from one nursing facility to19371
another nursing facility, with or without an intervening hospital19372
stay.19373

       (C) Except as provided in rules adopted under division (F)(3) 19374
of this section, the department of mental retardation and19375
developmental disabilities shall review and determine, for each19376
resident of a nursing facility who is mentally retarded, whether19377
the resident, because of the resident's physical and mental19378
condition, requires the level of services provided by a nursing 19379
facility and whether the resident requires specialized services 19380
for mental retardation. The review and determination shall be 19381
conducted in accordance with section 1919(e)(7) of the "Social 19382
Security Act" and the regulations adopted under section 19383
1919(f)(8)(A) of the act. The review and determination shall be 19384
completed promptly after a nursing facility has notified the19385
department that there has been a significant change in the 19386
resident's mental or physical condition.19387

       (D)(1) In the case of a nursing facility resident who has19388
continuously resided in a nursing facility for at least thirty19389
months before the date of a review and determination under19390
division (C) of this section, if the resident is determined not to 19391
require the level of services provided by a nursing facility, but 19392
is determined to require specialized services for mental19393
retardation, the department, in consultation with the resident's19394
family or legal representative and care givers, shall do all of19395
the following:19396

       (a) Inform the resident of the institutional and19397
noninstitutional alternatives covered under the state medicaid19398
plan for medical assistance;19399

       (b) Offer the resident the choice of remaining in the nursing 19400
facility or receiving covered services in an alternative19401
institutional or noninstitutional setting;19402

       (c) Clarify the effect on eligibility for services under the 19403
state medicaid plan for medical assistance if the resident chooses 19404
to leave the facility, including its effect on readmission to the19405
facility;19406

       (d) Provide for or arrange for the provision of specialized 19407
services for the resident's mental retardation in the setting 19408
chosen by the resident.19409

       (2) In the case of a nursing facility resident who has19410
continuously resided in a nursing facility for less than thirty19411
months before the date of the review and determination under19412
division (C) of this section, if the resident is determined not to 19413
require the level of services provided by a nursing facility, but 19414
is determined to require specialized services for mental 19415
retardation, or if the resident is determined to require neither 19416
the level of services provided by a nursing facility nor 19417
specialized services for mental retardation, the department shall 19418
act in accordance with its alternative disposition plan approved 19419
by the United States department of health and human services under19420
section 1919(e)(7)(E) of the "Social Security Act."19421

       (3) In the case of an individual who is determined under19422
division (B) or (C) of this section to require both the level of19423
services provided by a nursing facility and specialized services19424
for mental retardation, the department of mental retardation and19425
developmental disabilities shall provide or arrange for the19426
provision of the specialized services needed by the individual or19427
resident while residing in a nursing facility.19428

       (E) The department of mental retardation and developmental19429
disabilities shall adopt rules in accordance with Chapter 119. of19430
the Revised Code that do all of the following:19431

       (1) Establish criteria to be used in making the19432
determinations required by divisions (B) and (C) of this section.19433
The criteria shall not exceed the criteria established by19434
regulations adopted by the United States department of health and19435
human services under section 1919(f)(8)(A) of the "Social Security 19436
Act."19437

       (2) Specify information to be provided by the individual or 19438
nursing facility resident being assessed;19439

       (3) Specify any circumstances, in addition to circumstances 19440
listed in division (B) of this section, under which determinations 19441
under divisions (B) and (C) of this section are not required to be 19442
made.19443

       Sec. 5123.0412. (A) The department of mental retardation and19444
developmental disabilities shall charge each county board of19445
mental retardation and developmental disabilities an annual fee19446
equal to one and one-half per cent of the total value of all 19447
medicaid paid claims for home and community-based services 19448
provided during the year to an individual eligible for services 19449
from the county board. No county board shall pass the cost of a 19450
fee charged to the county board under this section on to another 19451
provider of these services.19452

       (B) The fees collected under this section shall be deposited19453
into the ODMR/DD administration and oversight fund and the ODJFS19454
ODHCA administration and oversight fund, both of which are hereby19455
created in the state treasury. The portion of the fees to be19456
deposited into the ODMR/DD administration and oversight fund and19457
the portion of the fees to be deposited into the ODJFSODHCA19458
administration and oversight fund shall be the portion specified19459
in an interagency agreement entered into under division (C) of19460
this section. The department of mental retardation and19461
developmental disabilities shall use the money in the ODMR/DD19462
administration and oversight fund and the department of job and19463
family serviceshealth care administration shall use the money in 19464
the ODJFSODHCA administration and oversight fund for both of the 19465
following purposes:19466

       (1) The administrative and oversight costs of medicaid case 19467
management services and home and community-based services. The 19468
administrative and oversight costs shall include costs for staff, 19469
systems, and other resources the departments need and dedicate 19470
solely to the following duties associated with the services:19471

       (a) Eligibility determinations;19472

       (b) Training;19473

       (c) Fiscal management;19474

       (d) Claims processing;19475

       (e) Quality assurance oversight;19476

       (f) Other duties the departments identify.19477

       (2) Providing technical support to county boards' local19478
administrative authority under section 5126.055 of the Revised19479
Code for the services.19480

       (C) The departments of mental retardation and developmental19481
disabilities and job and family serviceshealth care 19482
administration shall enter into an interagency agreement to do 19483
both of the following:19484

       (1) Specify which portion of the fees collected under this19485
section is to be deposited into the ODMR/DD administration and19486
oversight fund and which portion is to be deposited into the ODJFS19487
ODHCA administration and oversight fund;19488

       (2) Provide for the departments to coordinate the staff whose 19489
costs are paid for with money in the ODMR/DD administration and 19490
oversight fund and the ODJFSODHCA administration and oversight19491
fund.19492

       (D) The departments shall submit an annual report to the19493
director of budget and management certifying how the departments19494
spent the money in the ODMR/DD administration and oversight fund19495
and the ODJFSODHCA administration and oversight fund for the 19496
purposes specified in division (B) of this section.19497

       Sec. 5123.0417. (A) Using funds available under section 19498
5112.3715166.481 of the Revised Code, the director of mental 19499
retardation and developmental disabilities shall establish one or 19500
more programs for individuals under twenty-one years of age who 19501
have intensive behavioral needs, including such individuals with 19502
a primary diagnosis of autism spectrum disorder. The programs may 19503
include one or more medicaid waiver components that the director 19504
administers pursuant to section 5111.8715163.651 of the Revised 19505
Code. The programs may do one or more of the following:19506

        (1) Establish models that incorporate elements common to 19507
effective intervention programs and evidence-based practices in 19508
services for children with intensive behavioral needs; 19509

       (2) Design a template for individualized education plans and 19510
individual service plans that provide consistent intervention 19511
programs and evidence-based practices for the care and treatment 19512
of children with intensive behavioral needs;19513

        (3) Disseminate best practice guidelines for use by families 19514
of children with intensive behavioral needs and professionals 19515
working with such families; 19516

       (4) Develop a transition planning model for effectively 19517
mainstreaming school-age children with intensive behavioral needs 19518
to their public school district;19519

        (5) Contribute to the field of early and effective 19520
identification and intervention programs for children with 19521
intensive behavioral needs by providing financial support for 19522
scholarly research and publication of clinical findings.19523

        (B) The director of mental retardation and developmental 19524
disabilities shall collaborate with the director of job and family 19525
serviceshealth care administration and consult with the executive 19526
director of the Ohio center for autism and low incidence and 19527
university-based programs that specialize in services for 19528
individuals with developmental disabilities when establishing 19529
programs under this section. 19530

       Sec. 5123.171.  As used in this section, "respite care" means 19531
appropriate, short-term, temporary care provided to a mentally 19532
retarded or developmentally disabled person to sustain the family 19533
structure or to meet planned or emergency needs of the family.19534

       The department of mental retardation and developmental19535
disabilities shall provide respite care services to persons with19536
mental retardation or a developmental disability for the purpose19537
of promoting self-sufficiency and normalization, preventing or19538
reducing inappropriate institutional care, and furthering the19539
unity of the family by enabling the family to meet the special19540
needs of a mentally retarded or developmentally disabled person.19541

       In order to be eligible for respite care services under this 19542
section, the mentally retarded or developmentally disabled person 19543
must be in need of habilitation services as defined in section 19544
5126.01 of the Revised Code.19545

       Respite care may be provided in a facility licensed under19546
section 5123.19 of the Revised Code or certified as an19547
intermediate care facility for the mentally retarded under Title19548
XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.19549
301, as amended,medicaid program or certified as a respite care 19550
home under section 5126.05 of the Revised Code.19551

       The department shall develop a system for locating vacant19552
beds that are available for respite care and for making19553
information on vacant beds available to users of respite care19554
services. Facilities certified as intermediate care facilities for 19555
the mentally retarded and facilities holding contracts with the 19556
department for the provision of residential services under section 19557
5123.18 of the Revised Code shall report vacant beds to the 19558
department but shall not be required to accept respite care19559
clients.19560

       The director of mental retardation and developmental19561
disabilities shall adopt, and may amend or rescind, rules in19562
accordance with Chapter 119. of the Revised Code for both of the19563
following:19564

       (A) Certification by county boards of mental retardation and 19565
developmental disabilities of respite care homes;19566

       (B) Provision of respite care services authorized by this19567
section. Rules adopted under this division shall establish all of 19568
the following:19569

       (1) A formula for distributing funds appropriated for respite 19570
care services;19571

       (2) Standards for supervision, training and quality control 19572
in the provision of respite care services;19573

       (3) Eligibility criteria for emergency respite care services.19574

       Sec. 5123.181.  The director of mental retardation and19575
developmental disabilities and the director of job and family 19576
serviceshealth care administration shall, in concert with each 19577
other, eliminate all double billings and double payments for 19578
services on behalf of persons with mental retardation or another19579
developmental disability in intermediate care facilities. The 19580
department of mental retardation and developmental disabilities 19581
may enter into contracts with providers of services for the 19582
purpose of making payments to the providers for services rendered 19583
to eligible clients who are persons with mental retardation or a 19584
developmental disability over and above the services authorized 19585
and paid under Chapter 5111. of the Revised Codemedicaid program. 19586
Payments authorized under this section and section 5123.18 of the 19587
Revised Code shall not be subject to audit findings pursuant to 19588
Chapter 5111. ofunder the Revised Codemedicaid program, unless19589
an audit determines that payment was made to the provider for19590
services that were not rendered in accordance with the provisions19591
of the provider agreement entered into with the department of job 19592
and family serviceshealth care administration or the department 19593
of mental retardation and developmental disabilities pursuant to 19594
this section.19595

       Sec. 5123.19.  (A) As used in this section and in sections19596
5123.191, 5123.194, 5123.196, 5123.198, and 5123.20 of the Revised 19597
Code:19598

       (1)(a) "Residential facility" means a home or facility in19599
which a mentally retarded or developmentally disabled person19600
resides, except the home of a relative or legal guardian in which19601
a mentally retarded or developmentally disabled person resides, a19602
respite care home certified under section 5126.05 of the Revised19603
Code, a county home or district home operated pursuant to Chapter19604
5155. of the Revised Code, or a dwelling in which the only19605
mentally retarded or developmentally disabled residents are in an19606
independent living arrangement or are being provided supported19607
living.19608

        (b) "Intermediate care facility for the mentally retarded" 19609
means a residential facility that is considered an intermediate 19610
care facility for the mentally retarded for the purposes of19611
Chapter 5111. of the Revised Codemedicaid program.19612

       (2) "Political subdivision" means a municipal corporation,19613
county, or township.19614

       (3) "Independent living arrangement" means an arrangement in19615
which a mentally retarded or developmentally disabled person19616
resides in an individualized setting chosen by the person or the19617
person's guardian, which is not dedicated principally to the19618
provision of residential services for mentally retarded or19619
developmentally disabled persons, and for which no financial19620
support is received for rendering such service from any19621
governmental agency by a provider of residential services.19622

        (4) "Licensee" means the person or government agency that has 19623
applied for a license to operate a residential facility and to19624
which the license was issued under this section.19625

       (5) "Related party" has the same meaning as in section 19626
5123.16 of the Revised Code except that "provider" as used in the 19627
definition of "related party" means a person or government entity 19628
that held or applied for a license to operate a residential 19629
facility, rather than a person or government entity certified to 19630
provide supported living.19631

       (B) Every person or government agency desiring to operate a19632
residential facility shall apply for licensure of the facility to19633
the director of mental retardation and developmental disabilities19634
unless the residential facility is subject to section 3721.02,19635
3722.04, 5103.03, or 5119.20 of the Revised Code. Notwithstanding19636
Chapter 3721. of the Revised Code, a nursing home that is19637
certified as an intermediate care facility for the mentally19638
retarded under Title XIX offor the "Social Security Act," 79 19639
Stat. 286 (1965), 42 U.S.C.A. 1396, as amended,medicaid program19640
shall apply for licensure of the portion of the home that is 19641
certified as an intermediate care facility for the mentally 19642
retarded.19643

       (C) Subject to section 5123.196 of the Revised Code, the 19644
director of mental retardation and developmental disabilities 19645
shall license the operation of residential facilities. An initial 19646
license shall be issued for a period that does not exceed one 19647
year, unless the director denies the license under division (D) of 19648
this section. A license shall be renewed for a period that does 19649
not exceed three years, unless the director refuses to renew the 19650
license under division (D) of this section. The director, when19651
issuing or renewing a license, shall specify the period for which19652
the license is being issued or renewed. A license remains valid19653
for the length of the licensing period specified by the director,19654
unless the license is terminated, revoked, or voluntarily19655
surrendered.19656

       (D) If it is determined that an applicant or licensee is not 19657
in compliance with a provision of this chapter that applies to19658
residential facilities or the rules adopted under such a19659
provision, the director may deny issuance of a license, refuse to19660
renew a license, terminate a license, revoke a license, issue an19661
order for the suspension of admissions to a facility, issue an19662
order for the placement of a monitor at a facility, issue an order19663
for the immediate removal of residents, or take any other action19664
the director considers necessary consistent with the director's19665
authority under this chapter regarding residential facilities. In19666
the director's selection and administration of the sanction to be19667
imposed, all of the following apply:19668

       (1) The director may deny, refuse to renew, or revoke a19669
license, if the director determines that the applicant or licensee19670
has demonstrated a pattern of serious noncompliance or that a19671
violation creates a substantial risk to the health and safety of19672
residents of a residential facility.19673

       (2) The director may terminate a license if more than twelve19674
consecutive months have elapsed since the residential facility was19675
last occupied by a resident or a notice required by division (K)19676
of this section is not given.19677

       (3) The director may issue an order for the suspension of19678
admissions to a facility for any violation that may result in19679
sanctions under division (D)(1) of this section and for any other19680
violation specified in rules adopted under division (H)(2) of 19681
this section. If the suspension of admissions is imposed for a19682
violation that may result in sanctions under division (D)(1) of19683
this section, the director may impose the suspension before19684
providing an opportunity for an adjudication under Chapter 119. of19685
the Revised Code. The director shall lift an order for the19686
suspension of admissions when the director determines that the19687
violation that formed the basis for the order has been corrected.19688

       (4) The director may order the placement of a monitor at a19689
residential facility for any violation specified in rules adopted19690
under division (H)(2) of this section. The director shall lift the 19691
order when the director determines that the violation that formed 19692
the basis for the order has been corrected.19693

       (5) If the director determines that two or more residential19694
facilities owned or operated by the same person or government19695
entity are not being operated in compliance with a provision of19696
this chapter that applies to residential facilities or the rules19697
adopted under such a provision, and the director's findings are19698
based on the same or a substantially similar action, practice,19699
circumstance, or incident that creates a substantial risk to the19700
health and safety of the residents, the director shall conduct a19701
survey as soon as practicable at each residential facility owned19702
or operated by that person or government entity. The director may19703
take any action authorized by this section with respect to any19704
facility found to be operating in violation of a provision of this19705
chapter that applies to residential facilities or the rules19706
adopted under such a provision.19707

       (6) When the director initiates license revocation19708
proceedings, no opportunity for submitting a plan of correction19709
shall be given. The director shall notify the licensee by letter19710
of the initiation of the proceedings. The letter shall list the19711
deficiencies of the residential facility and inform the licensee19712
that no plan of correction will be accepted. The director shall19713
also send a copy of the letter to the county board of mental 19714
retardation and developmental disabilities. The county board shall 19715
send a copy of the letter to each of the following:19716

        (a) Each resident who receives services from the licensee;19717

        (b) The guardian of each resident who receives services from 19718
the licensee if the resident has a guardian;19719

        (c) The parent or guardian of each resident who receives 19720
services from the licensee if the resident is a minor.19721

       (7) Pursuant to rules which shall be adopted in accordance19722
with Chapter 119. of the Revised Code, the director may order the19723
immediate removal of residents from a residential facility19724
whenever conditions at the facility present an immediate danger of19725
physical or psychological harm to the residents.19726

       (8) In determining whether a residential facility is being19727
operated in compliance with a provision of this chapter that19728
applies to residential facilities or the rules adopted under such19729
a provision, or whether conditions at a residential facility19730
present an immediate danger of physical or psychological harm to19731
the residents, the director may rely on information obtained by a19732
county board of mental retardation and developmental disabilities19733
or other governmental agencies.19734

       (9) In proceedings initiated to deny, refuse to renew, or19735
revoke licenses, the director may deny, refuse to renew, or revoke19736
a license regardless of whether some or all of the deficiencies19737
that prompted the proceedings have been corrected at the time of19738
the hearing.19739

       (E) The director shall establish a program under which public 19740
notification may be made when the director has initiated license 19741
revocation proceedings or has issued an order for the suspension 19742
of admissions, placement of a monitor, or removal of residents. 19743
The director shall adopt rules in accordance with Chapter 119. of 19744
the Revised Code to implement this division. The rules shall 19745
establish the procedures by which the public notification will be 19746
made and specify the circumstances for which the notification must 19747
be made. The rules shall require that public notification be made 19748
if the director has taken action against the facility in the 19749
eighteen-month period immediately preceding the director's latest 19750
action against the facility and the latest action is being taken 19751
for the same or a substantially similar violation of a provision 19752
of this chapter that applies to residential facilities or the 19753
rules adopted under such a provision. The rules shall specify a 19754
method for removing or amending the public notification if the19755
director's action is found to have been unjustified or the19756
violation at the residential facility has been corrected.19757

       (F)(1) Except as provided in division (F)(2) of this section,19758
appeals from proceedings initiated to impose a sanction under 19759
division (D) of this section shall be conducted in accordance with 19760
Chapter 119. of the Revised Code.19761

       (2) Appeals from proceedings initiated to order the19762
suspension of admissions to a facility shall be conducted in19763
accordance with Chapter 119. of the Revised Code, unless the order19764
was issued before providing an opportunity for an adjudication, in19765
which case all of the following apply:19766

       (a) The licensee may request a hearing not later than ten19767
days after receiving the notice specified in section 119.07 of the19768
Revised Code.19769

       (b) If a timely request for a hearing that includes the 19770
licensee's current address is made, the hearing shall commence not 19771
later than thirty days after the department receives the request.19772

       (c) After commencing, the hearing shall continue19773
uninterrupted, except for Saturdays, Sundays, and legal holidays,19774
unless other interruptions are agreed to by the licensee and the19775
director.19776

       (d) If the hearing is conducted by a hearing examiner, the19777
hearing examiner shall file a report and recommendations not later19778
than ten days after the last of the following:19779

       (i) The close of the hearing;19780

       (ii) If a transcript of the proceedings is ordered, the 19781
hearing examiner receives the transcript;19782

        (iii) If post-hearing briefs are timely filed, the hearing 19783
examiner receives the briefs.19784

       (e) A copy of the written report and recommendation of the 19785
hearing examiner shall be sent, by certified mail, to the licensee 19786
and the licensee's attorney, if applicable, not later than five 19787
days after the report is filed.19788

        (f) Not later than five days after the hearing examiner files 19789
the report and recommendations, the licensee may file objections 19790
to the report and recommendations.19791

       (g) Not later than fifteen days after the hearing examiner19792
files the report and recommendations, the director shall issue an19793
order approving, modifying, or disapproving the report and19794
recommendations.19795

       (h) Notwithstanding the pendency of the hearing, the director 19796
shall lift the order for the suspension of admissions when the 19797
director determines that the violation that formed the basis for 19798
the order has been corrected.19799

       (G) Neither a person or government agency whose application 19800
for a license to operate a residential facility is denied nor a 19801
related party of the person or government agency may apply for a 19802
license to operate a residential facility before the date that is 19803
one year after the date of the denial. Neither a licensee whose 19804
residential facility license is revoked nor a related party of the 19805
licensee may apply for a residential facility license before the 19806
date that is five years after the date of the revocation.19807

        (H) In accordance with Chapter 119. of the Revised Code, the19808
director shall adopt and may amend and rescind rules for licensing19809
and regulating the operation of residential facilities, including 19810
intermediate care facilities for the mentally retarded. The rules 19811
for intermediate care facilities for the mentally retarded may 19812
differ from those for other residential facilities. The rules19813
shall establish and specify the following:19814

       (1) Procedures and criteria for issuing and renewing19815
licenses, including procedures and criteria for determining the19816
length of the licensing period that the director must specify for19817
each license when it is issued or renewed;19818

       (2) Procedures and criteria for denying, refusing to renew,19819
terminating, and revoking licenses and for ordering the suspension19820
of admissions to a facility, placement of a monitor at a facility,19821
and the immediate removal of residents from a facility;19822

       (3) Fees for issuing and renewing licenses, which shall be 19823
deposited into the program fee fund created under section 5123.033 19824
of the Revised Code;19825

       (4) Procedures for surveying residential facilities;19826

       (5) Requirements for the training of residential facility19827
personnel;19828

       (6) Classifications for the various types of residential19829
facilities;19830

       (7) Certification procedures for licensees and management19831
contractors that the director determines are necessary to ensure19832
that they have the skills and qualifications to properly operate19833
or manage residential facilities;19834

       (8) The maximum number of persons who may be served in a19835
particular type of residential facility;19836

       (9) Uniform procedures for admission of persons to and19837
transfers and discharges of persons from residential facilities;19838

       (10) Other standards for the operation of residential19839
facilities and the services provided at residential facilities;19840

       (11) Procedures for waiving any provision of any rule adopted 19841
under this section.19842

       (I) Before issuing a license, the director of the department19843
or the director's designee shall conduct a survey of the19844
residential facility for which application is made. The director19845
or the director's designee shall conduct a survey of each 19846
licensed residential facility at least once during the period the 19847
license is valid and may conduct additional inspections as needed. 19848
A survey includes but is not limited to an on-site examination and19849
evaluation of the residential facility, its personnel, and the19850
services provided there.19851

       In conducting surveys, the director or the director's19852
designee shall be given access to the residential facility; all 19853
records, accounts, and any other documents related to the 19854
operation of the facility; the licensee; the residents of the 19855
facility; and all persons acting on behalf of, under the control 19856
of, or in connection with the licensee. The licensee and all 19857
persons on behalf of, under the control of, or in connection with 19858
the licensee shall cooperate with the director or the director's19859
designee in conducting the survey.19860

       Following each survey, unless the director initiates a 19861
license revocation proceeding, the director or the director's 19862
designee shall provide the licensee with a report listing any 19863
deficiencies, specifying a timetable within which the licensee 19864
shall submit a plan of correction describing how the deficiencies 19865
will be corrected, and, when appropriate, specifying a timetable 19866
within which the licensee must correct the deficiencies. After a 19867
plan of correction is submitted, the director or the director's19868
designee shall approve or disapprove the plan. A copy of the 19869
report and any approved plan of correction shall be provided to 19870
any person who requests it.19871

       The director shall initiate disciplinary action against any19872
department employee who notifies or causes the notification to any19873
unauthorized person of an unannounced survey of a residential 19874
facility by an authorized representative of the department.19875

       (J) In addition to any other information which may be19876
required of applicants for a license pursuant to this section, the19877
director shall require each applicant to provide a copy of an19878
approved plan for a proposed residential facility pursuant to19879
section 5123.042 of the Revised Code. This division does not apply19880
to renewal of a license.19881

       (K) A licensee shall notify the owner of the building in19882
which the licensee's residential facility is located of any19883
significant change in the identity of the licensee or management19884
contractor before the effective date of the change if the licensee19885
is not the owner of the building.19886

       Pursuant to rules which shall be adopted in accordance with19887
Chapter 119. of the Revised Code, the director may require19888
notification to the department of any significant change in the19889
ownership of a residential facility or in the identity of the19890
licensee or management contractor. If the director determines that 19891
a significant change of ownership is proposed, the director shall19892
consider the proposed change to be an application for development19893
by a new operator pursuant to section 5123.042 of the Revised Code19894
and shall advise the applicant within sixty days of the19895
notification that the current license shall continue in effect or19896
a new license will be required pursuant to this section. If the19897
director requires a new license, the director shall permit the19898
facility to continue to operate under the current license until19899
the new license is issued, unless the current license is revoked,19900
refused to be renewed, or terminated in accordance with Chapter19901
119. of the Revised Code.19902

       (L) A county board of mental retardation and developmental19903
disabilities, the legal rights service, and any interested person19904
may file complaints alleging violations of statute or department19905
rule relating to residential facilities with the department. All19906
complaints shall be in writing and shall state the facts19907
constituting the basis of the allegation. The department shall not 19908
reveal the source of any complaint unless the complainant agrees 19909
in writing to waive the right to confidentiality or until so 19910
ordered by a court of competent jurisdiction.19911

       The department shall adopt rules in accordance with Chapter 19912
119. of the Revised Code establishing procedures for the receipt, 19913
referral, investigation, and disposition of complaints filed with 19914
the department under this division.19915

       (M) The department shall establish procedures for the19916
notification of interested parties of the transfer or interim care19917
of residents from residential facilities that are closing or are19918
losing their license.19919

       (N) Before issuing a license under this section to a19920
residential facility that will accommodate at any time more than19921
one mentally retarded or developmentally disabled individual, the19922
director shall, by first class mail, notify the following:19923

       (1) If the facility will be located in a municipal19924
corporation, the clerk of the legislative authority of the19925
municipal corporation;19926

       (2) If the facility will be located in unincorporated19927
territory, the clerk of the appropriate board of county19928
commissioners and the fiscal officer of the appropriate board of 19929
township trustees.19930

       The director shall not issue the license for ten days after19931
mailing the notice, excluding Saturdays, Sundays, and legal19932
holidays, in order to give the notified local officials time in19933
which to comment on the proposed issuance.19934

       Any legislative authority of a municipal corporation, board19935
of county commissioners, or board of township trustees that19936
receives notice under this division of the proposed issuance of a19937
license for a residential facility may comment on it in writing to19938
the director within ten days after the director mailed the notice,19939
excluding Saturdays, Sundays, and legal holidays. If the director19940
receives written comments from any notified officials within the19941
specified time, the director shall make written findings19942
concerning the comments and the director's decision on the19943
issuance of the license. If the director does not receive written19944
comments from any notified local officials within the specified19945
time, the director shall continue the process for issuance of the19946
license.19947

       (O) Any person may operate a licensed residential facility19948
that provides room and board, personal care, habilitation19949
services, and supervision in a family setting for at least six but19950
not more than eight persons with mental retardation or a19951
developmental disability as a permitted use in any residential19952
district or zone, including any single-family residential district19953
or zone, of any political subdivision. These residential19954
facilities may be required to comply with area, height, yard, and19955
architectural compatibility requirements that are uniformly19956
imposed upon all single-family residences within the district or19957
zone.19958

       (P) Any person may operate a licensed residential facility 19959
that provides room and board, personal care, habilitation19960
services, and supervision in a family setting for at least nine19961
but not more than sixteen persons with mental retardation or a19962
developmental disability as a permitted use in any multiple-family19963
residential district or zone of any political subdivision, except19964
that a political subdivision that has enacted a zoning ordinance19965
or resolution establishing planned unit development districts may19966
exclude these residential facilities from those districts, and a19967
political subdivision that has enacted a zoning ordinance or19968
resolution may regulate these residential facilities in19969
multiple-family residential districts or zones as a conditionally19970
permitted use or special exception, in either case, under19971
reasonable and specific standards and conditions set out in the19972
zoning ordinance or resolution to:19973

       (1) Require the architectural design and site layout of the19974
residential facility and the location, nature, and height of any19975
walls, screens, and fences to be compatible with adjoining land19976
uses and the residential character of the neighborhood;19977

       (2) Require compliance with yard, parking, and sign19978
regulation;19979

       (3) Limit excessive concentration of these residential19980
facilities.19981

       (Q) This section does not prohibit a political subdivision19982
from applying to residential facilities nondiscriminatory19983
regulations requiring compliance with health, fire, and safety19984
regulations and building standards and regulations.19985

       (R) Divisions (O) and (P) of this section are not applicable 19986
to municipal corporations that had in effect on June 15, 1977, an 19987
ordinance specifically permitting in residential zones licensed 19988
residential facilities by means of permitted uses, conditional 19989
uses, or special exception, so long as such ordinance remains in 19990
effect without any substantive modification.19991

       (S)(1) The director may issue an interim license to operate a19992
residential facility to an applicant for a license under this19993
section if either of the following is the case:19994

       (a) The director determines that an emergency exists 19995
requiring immediate placement of persons in a residential19996
facility, that insufficient licensed beds are available, and that 19997
the residential facility is likely to receive a permanent license 19998
under this section within thirty days after issuance of the 19999
interim license.20000

       (b) The director determines that the issuance of an interim20001
license is necessary to meet a temporary need for a residential20002
facility.20003

       (2) To be eligible to receive an interim license, an20004
applicant must meet the same criteria that must be met to receive20005
a permanent license under this section, except for any differing20006
procedures and time frames that may apply to issuance of a20007
permanent license.20008

       (3) An interim license shall be valid for thirty days and may20009
be renewed by the director for a period not to exceed one hundred 20010
fifty days.20011

       (4) The director shall adopt rules in accordance with Chapter 20012
119. of the Revised Code as the director considers necessary to 20013
administer the issuance of interim licenses.20014

       (T) Notwithstanding rules adopted pursuant to this section20015
establishing the maximum number of persons who may be served in a20016
particular type of residential facility, a residential facility20017
shall be permitted to serve the same number of persons being20018
served by the facility on the effective date of the rules or the20019
number of persons for which the facility is authorized pursuant to 20020
a current application for a certificate of need with a letter of 20021
support from the department of mental retardation and20022
developmental disabilities and which is in the review process20023
prior to April 4, 1986.20024

       (U) The director or the director's designee may enter at any 20025
time, for purposes of investigation, any home, facility, or other20026
structure that has been reported to the director or that the20027
director has reasonable cause to believe is being operated as a20028
residential facility without a license issued under this section.20029

       The director may petition the court of common pleas of the20030
county in which an unlicensed residential facility is located for20031
an order enjoining the person or governmental agency operating the20032
facility from continuing to operate without a license. The court20033
may grant the injunction on a showing that the person or20034
governmental agency named in the petition is operating a20035
residential facility without a license. The court may grant the20036
injunction, regardless of whether the residential facility meets20037
the requirements for receiving a license under this section.20038

       Sec. 5123.192.  Notwithstanding section 5123.19 of the 20039
Revised Code, any nursing home that on June 30, 1987, contained 20040
beds that the department of health had certified prior to June 30, 20041
1987, as intermediate care facility for the mentally retarded beds 20042
under Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 20043
42 U.S.C. 301, as amended,medicaid program or any nursing home 20044
that on June 30, 1987, had an application pending before the 20045
department to convert intermediate care facility beds to 20046
intermediate care facility for the mentally retarded beds, shall 20047
not be required to apply for licensure under section 5123.19 of 20048
the Revised Code, shall be subject to the requirements for20049
licensure as a nursing home and all other requirements of Chapter 20050
3721. of the Revised Code and any rules adopted under that 20051
chapter, and shall be subject to sections 3702.51 to 3702.62 of 20052
the Revised Code and any rules adopted under those sections, 20053
unless either of the following applies:20054

       (A) The nursing home's certification or provider agreement as 20055
an intermediate care facility for the mentally retarded is subject 20056
to a final order of nonrenewal or termination with respect to 20057
which all appeal rights have been exhausted and the facility 20058
intends to apply for recertification;20059

       (B) The nursing home intends to increase its number of beds 20060
certified as intermediate care facility for the mentally retarded 20061
beds. In such a case, the nursing home shall be required to apply 20062
for licensure of the additional beds under section 5123.19 of the 20063
Revised Code.20064

       Sec. 5123.198. (A) As used in this section, "date of the 20065
commitment" means the date that an individual specified in 20066
division (B) of this section begins to reside in a state-operated 20067
intermediate care facility for the mentally retarded after being 20068
committed to the facility pursuant to sections 5123.71 to 5123.76 20069
of the Revised Code.20070

       (B) Except as provided in division (C) of this section, 20071
whenever a resident of a residential facility is committed to a 20072
state-operated intermediate care facility for the mentally 20073
retarded pursuant to sections 5123.71 to 5123.76 of the Revised 20074
Code, the department of mental retardation and developmental 20075
disabilities, pursuant to an adjudication order issued in 20076
accordance with Chapter 119. of the Revised Code, shall reduce by 20077
one the number of residents for which the facility in which the 20078
resident resided is licensed. 20079

       (C) The department shall not reduce under division (B) of 20080
this section the number of residents for which a residential 20081
facility is licensed if any of the following are the case:20082

       (1) The resident of the residential facility who is committed 20083
to a state-operated intermediate care facility for the mentally 20084
retarded resided in the residential facility because of the 20085
closure, on or after June 26, 2003, of another state-operated 20086
intermediate care facility for the mentally retarded;20087

       (2) The residential facility admits within ninety days of the 20088
date of the commitment an individual who resides on the date of 20089
the commitment in a state-operated intermediate care facility for 20090
the mentally retarded or another residential facility;20091

       (3) The department fails to do either of the following within 20092
ninety days of the date of the commitment:20093

       (a) Identify an individual to whom all of the following 20094
applies:20095

       (i) Resides on the date of the commitment in a state-operated 20096
intermediate care facility for the mentally retarded or another 20097
residential facility;20098

       (ii) Has indicated to the department an interest in 20099
relocating to the residential facility or has a parent or guardian 20100
who has indicated to the department an interest for the individual 20101
to relocate to the residential facility;20102

       (iii) The department determines the individual has needs that 20103
the residential facility can meet.20104

       (b) Provide the residential facility with information about 20105
the individual identified under division (C)(2)(a) of this section 20106
that the residential facility needs in order to determine whether 20107
the facility can meet the individual's needs.20108

       (4) If the department completes the actions specified in 20109
divisions (C)(3)(a) and (b) of this section not later than ninety 20110
days after the date of the commitment and except as provided in 20111
division (D) of this section, the residential facility does all of 20112
the following not later than ninety days after the date of the 20113
commitment:20114

       (a) Evaluates the information provided by the department;20115

       (b) Assesses the identified individual's needs;20116

       (c) Determines that the residential facility cannot meet the 20117
identified individual's needs.20118

       (5) If the department completes the actions specified in 20119
divisions (C)(3)(a) and (b) of this section not later than ninety 20120
days after the date of the commitment and the residential facility 20121
determines that the residential facility can meet the identified 20122
individual's needs, the individual, or a parent or guardian of the 20123
individual, refuses placement in the residential facility.20124

       (D) The department may reduce under division (B) of this 20125
section the number of residents for which a residential facility 20126
is licensed even though the residential facility completes the 20127
actions specified in division (C)(4) of this section not later 20128
than ninety days after the date of the commitment if all of the 20129
following are the case:20130

       (1) The department disagrees with the residential facility's 20131
determination that the residential facility cannot meet the 20132
identified individual's needs.20133

       (2) The department issues a written decision pursuant to the 20134
uniform procedures for admissions, transfers, and discharges 20135
established by rules adopted under division (H)(9) of section 20136
5123.19 of the Revised Code that the residential facility should 20137
admit the identified individual.20138

       (3) After the department issues the written decision 20139
specified in division (D)(2) of this section, the residential 20140
facility refuses to admit the identified individual.20141

       (E) A residential facility that admits, refuses to admit, 20142
transfers, or discharges a resident under this section shall 20143
comply with the uniform procedures for admissions, transfers, and 20144
discharges established by rules adopted under division (H)(9) of 20145
section 5123.19 of the Revised Code.20146

       (F) The department of mental retardation and developmental 20147
disabilities may notify the department of job and family services20148
health care administration of any reduction under this section in 20149
the number of residents for which a residential facility that is 20150
an intermediate care facility for the mentally retarded is 20151
licensed. On receiving the notice, the department of job and 20152
family serviceshealth care administration may transfer to the 20153
department of mental retardation and developmental disabilities 20154
the savings in the nonfederal share of medicaid expenditures for 20155
each fiscal year after the year of the commitment to be used for 20156
costs of the resident's care in the state-operated intermediate 20157
care facility for the mentally retarded. In determining the amount 20158
saved, the department of job and family serviceshealth care 20159
administration shall consider medicaid payments for the remaining 20160
residents of the facility in which the resident resided.20161

       Sec. 5123.211.  (A) As used in this section, "residential20162
services" has the same meaning as in section 5126.01 of the 20163
Revised Code.20164

       (B) The department of mental retardation and developmental20165
disabilities shall provide or arrange provision of residential20166
services for each person who, on or after July 1, 1989, ceases to20167
be a resident of a state institution because of closure of the20168
institution or a reduction in the institution's population by20169
forty per cent or more within a period of one year. The services20170
shall be provided in the county in which the person chooses to20171
reside and shall consist of one of the following as determined20172
appropriate by the department in consultation with the county20173
board of mental retardation and developmental disabilities of the20174
county in which the services are to be provided:20175

       (1) Residential services provided pursuant to section 5123.18 20176
of the Revised Code;20177

       (2) Residential services for which reimbursement is made20178
under the medical assistancemedicaid program established under 20179
section 5111.01 of the Revised Code;20180

       (3) Residential services provided in a manner or setting20181
approved by the director of mental retardation and developmental20182
disabilities.20183

       (C) Not less than six months prior to closing a state20184
institution or reducing a state institution's population by forty20185
per cent or more within a period of one year, the department shall 20186
identify those counties in which individuals leaving the20187
institution have chosen to reside and notify the county boards of20188
mental retardation and developmental disabilities in those20189
counties of the need to develop the services specified in division 20190
(B) of this section. The notice shall specify the number of 20191
individuals requiring services who plan to reside in the county 20192
and indicate the amount of funds the department will use to 20193
provide or arrange services for those individuals.20194

       (D) In each county in which one or more persons receive20195
residential services pursuant to division (B) of this section, the 20196
department shall provide or arrange provision of residential20197
services, or shall distribute moneys to the county board of mental 20198
retardation and developmental disabilities to provide or arrange 20199
provision of residential services, for an equal number of persons 20200
with mental retardation or developmental disabilities in that 20201
county who the county board has determined need residential20202
services but are not receiving them.20203

       Sec. 5123.71.  (A)(1) Proceedings for the involuntary20204
institutionalization of a person pursuant to sections 5123.71 to20205
5123.76 of the Revised Code shall be commenced by the filing of an20206
affidavit with the probate division of the court of common pleas20207
of the county where the person resides or where the person is20208
institutionalized, in the manner and form prescribed by the20209
department of mental retardation and developmental disabilities20210
either on information or actual knowledge, whichever is determined20211
to be proper by the court. The affidavit may be filed only by a20212
person who has custody of the individual as a parent, guardian, or20213
service provider or by a person acting on behalf of the department20214
or a county board of mental retardation and developmental20215
disabilities. This section does not apply regarding the20216
institutionalization of a person pursuant to section 2945.39,20217
2945.40, 2945.401, or 2945.402 of the Revised Code.20218

       The affidavit shall contain an allegation setting forth the20219
specific category or categories under division (O)(N) of section20220
5123.01 of the Revised Code upon which the commencement of20221
proceedings is based and a statement of the factual ground for the20222
belief that the person is a mentally retarded person subject to20223
institutionalization by court order. Except as provided in20224
division (A)(2) of this section, the affidavit shall be20225
accompanied by both of the following:20226

       (a) A comprehensive evaluation report prepared by the20227
person's evaluation team that includes a statement by the members20228
of the team certifying that they have performed a comprehensive20229
evaluation of the person and that they are of the opinion that the20230
person is a mentally retarded person subject to20231
institutionalization by court order;20232

       (b) An assessment report prepared by the county board of20233
mental retardation and developmental disabilities under section20234
5123.711 of the Revised Code specifying that the individual is in20235
need of services on an emergency or priority basis.20236

       (2) In lieu of the comprehensive evaluation report, the20237
affidavit may be accompanied by a written and sworn statement that20238
the person or the guardian of a person adjudicated incompetent has20239
refused to allow a comprehensive evaluation and county board20240
assessment and assessment reports. Immediately after accepting an20241
affidavit that is not accompanied by the reports of a20242
comprehensive evaluation and county board assessment, the court20243
shall cause a comprehensive evaluation and county board assessment20244
of the person named in the affidavit to be performed. The20245
evaluation shall be conducted in the least restrictive environment20246
possible and the assessment shall be conducted in the same manner20247
as assessments conducted under section 5123.711 of the Revised20248
Code. The evaluation and assessment must be completed before a20249
probable cause hearing or full hearing may be held under section20250
5123.75 or 5123.76 of the Revised Code.20251

       A written report of the evaluation team's findings and the20252
county board's assessment shall be filed with the court. The20253
reports shall, consistent with the rules of evidence, be accepted20254
as probative evidence in any proceeding under section 5123.75 or20255
5123.76 of the Revised Code. If the counsel for the person who is20256
evaluated or assessed is known, the court shall send to the20257
counsel a copy of the reports as soon as possible after they are20258
filed and prior to any proceedings under section 5123.75 or20259
5123.76 of the Revised Code.20260

       (B) Any person who is involuntarily detained in an20261
institution or otherwise is in custody under this chapter shall be20262
informed of the right to do the following:20263

       (1) Immediately make a reasonable number of telephone calls20264
or use other reasonable means to contact an attorney, a physician,20265
or both, to contact any other person or persons to secure20266
representation by counsel, or to obtain medical assistance, and be20267
provided assistance in making calls if the assistance is needed20268
and requested;20269

       (2) Retain counsel and have independent expert evaluation20270
and, if the person is an indigent person, be represented by20271
court-appointed counsel and have independent expert evaluation at20272
court expense;20273

       (3) Upon request, have a hearing to determine whether there20274
is probable cause to believe that the person is a mentally20275
retarded person subject to institutionalization by court order.20276

       (C) No person who is being treated by spiritual means through 20277
prayer alone in accordance with a recognized religious method of 20278
healing may be ordered detained or involuntarily committed unless 20279
the court has determined that the person represents a very 20280
substantial risk of self-impairment, self-injury, or impairment or 20281
injury to others.20282

       Sec. 5123.76.  (A) The full hearing shall be conducted in a20283
manner consistent with the procedures outlined in this chapter and20284
with due process of law. The hearing shall be held by a judge of20285
the probate division or, upon transfer by the judge of the probate20286
division, by another judge of the court of common pleas, or a20287
referee designated by the judge of the probate division. Any20288
referee designated by the judge of the probate division must be an20289
attorney.20290

       (1) The following shall be made available to counsel for the20291
respondent:20292

       (a) All relevant documents, information, and evidence in the20293
custody or control of the state or prosecutor;20294

       (b) All relevant documents, information, and evidence in the20295
custody or control of the institution, facility, or program in20296
which the respondent currently is held or in which the respondent20297
has been held pursuant to these proceedings;20298

       (c) With the consent of the respondent, all relevant20299
documents, information, and evidence in the custody or control of20300
any institution or person other than the state.20301

       (2) The respondent has the right to be represented by counsel 20302
of the respondent's choice and has the right to attend the hearing20303
except if unusual circumstances of compelling medical necessity20304
exist that render the respondent unable to attend and the20305
respondent has not expressed a desire to attend.20306

       (3) If the respondent is not represented by counsel and the20307
court determines that the conditions specified in division (A)(2)20308
of this section justify the respondent's absence and the right to20309
counsel has not been validly waived, the court shall appoint20310
counsel forthwith to represent the respondent at the hearing,20311
reserving the right to tax costs of appointed counsel to the20312
respondent unless it is shown that the respondent is indigent. If20313
the court appoints counsel, or if the court determines that the20314
evidence relevant to the respondent's absence does not justify the20315
absence, the court shall continue the case.20316

       (4) The respondent shall be informed of the right to retain20317
counsel, to have independent expert evaluation, and, if an20318
indigent person, to be represented by court appointed counsel and20319
have expert independent evaluation at court expense.20320

       (5) The hearing may be closed to the public unless counsel20321
for the respondent requests that the hearing be open to the20322
public.20323

       (6) Unless objected to by the respondent, the respondent's20324
counsel, or the designee of the director of mental retardation and20325
developmental disabilities, the court, for good cause shown, may20326
admit persons having a legitimate interest in the proceedings.20327

       (7) The affiant under section 5123.71 of the Revised Code20328
shall be subject to subpoena by either party.20329

       (8) The court shall examine the sufficiency of all documents20330
filed and shall inform the respondent, if present, and the20331
respondent's counsel of the nature of the content of the documents20332
and the reason for which the respondent is being held or for which20333
the respondent's placement is being sought.20334

       (9) The court shall receive only relevant, competent, and20335
material evidence.20336

       (10) The designee of the director shall present the evidence20337
for the state. In proceedings under this chapter, the attorney20338
general shall present the comprehensive evaluation, assessment,20339
diagnosis, prognosis, record of habilitation and care, if any, and20340
less restrictive habilitation plans, if any. The attorney general20341
does not have a similar presentation responsibility in connection20342
with a person who has been found not guilty by reason of insanity20343
and who is the subject of a hearing under section 2945.40 of the20344
Revised Code to determine whether the person is a mentally20345
retarded person subject to institutionalization by court order.20346

       (11) The respondent has the right to testify and the20347
respondent or the respondent's counsel has the right to subpoena20348
witnesses and documents and to present and cross-examine20349
witnesses.20350

       (12) The respondent shall not be compelled to testify and20351
shall be so advised by the court.20352

       (13) On motion of the respondent or the respondent's counsel20353
for good cause shown, or upon the court's own motion, the court20354
may order a continuance of the hearing.20355

       (14) To an extent not inconsistent with this chapter, the20356
Rules of Civil Procedure shall be applicable.20357

       (B) Unless, upon completion of the hearing, the court finds20358
by clear and convincing evidence that the respondent named in the20359
affidavit is a mentally retarded person subject to20360
institutionalization by court order, it shall order the20361
respondent's discharge forthwith.20362

       (C) If, upon completion of the hearing, the court finds by20363
clear and convincing evidence that the respondent is a mentally20364
retarded person subject to institutionalization by court order,20365
the court may order the respondent's discharge or order the20366
respondent, for a period not to exceed ninety days, to any of the20367
following:20368

       (1) A public institution, provided that commitment of the20369
respondent to the institution will not cause the institution to20370
exceed its licensed capacity determined in accordance with section20371
5123.19 of the Revised Code and provided that such a placement is20372
indicated by the comprehensive evaluation report filed pursuant to20373
section 5123.71 of the Revised Code;20374

       (2) A private institution;20375

       (3) A county mental retardation program;20376

       (4) Receive private habilitation and care;20377

       (5) Any other suitable facility, program, or the care of any20378
person consistent with the comprehensive evaluation, assessment,20379
diagnosis, prognosis, and habilitation needs of the respondent.20380

       (D) Any order made pursuant to division (C)(2), (4), or (5)20381
of this section shall be conditional upon the receipt by the court20382
of consent by the facility, program, or person to accept the20383
respondent.20384

       (E) In determining the place to which, or the person with20385
whom, the respondent is to be committed, the court shall consider20386
the comprehensive evaluation, assessment, diagnosis, and projected20387
habilitation plan for the respondent, and shall order the20388
implementation of the least restrictive alternative available and20389
consistent with habilitation goals.20390

       (F) If, at any time it is determined by the director of the20391
facility or program to which, or the person to whom, the20392
respondent is committed that the respondent could be equally well20393
habilitated in a less restrictive environment that is available,20394
the following shall occur:20395

       (1) The respondent shall be released by the director of the20396
facility or program or by the person forthwith and referred to the20397
court together with a report of the findings and recommendations20398
of the facility, program, or person.20399

       (2) The director of the facility or program or the person20400
shall notify the respondent's counsel and the designee of the20401
director of mental retardation and developmental disabilities.20402

       (3) The court shall dismiss the case or order placement in20403
the less restrictive environment.20404

       (G)(1) Except as provided in divisions (G)(2) and (3) of this 20405
section, any person who has been committed under this section may 20406
apply at any time during the ninety-day period for voluntary20407
admission to an institution under section 5123.69 of the Revised20408
Code. Upon admission of a voluntary resident, the managing officer 20409
immediately shall notify the court, the respondent's counsel, and 20410
the designee of the director in writing of that fact by mail or 20411
otherwise, and, upon receipt of the notice, the court shall 20412
dismiss the case.20413

       (2) A person who is found incompetent to stand trial or not20414
guilty by reason of insanity and who is committed pursuant to20415
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised20416
Code shall not be voluntarily admitted to an institution pursuant20417
to division (G)(1) of this section until after the termination of20418
the commitment, as described in division (J) of section 2945.40120419
of the Revised Code.20420

       (H) If, at the end of any commitment period, the respondent20421
has not already been discharged or has not requested voluntary20422
admission status, the director of the facility or program, or the20423
person to whose care the respondent has been committed, shall20424
discharge the respondent forthwith, unless at least ten days20425
before the expiration of that period the designee of the director20426
of mental retardation and developmental disabilities or the20427
prosecutor files an application with the court requesting20428
continued commitment.20429

       (1) An application for continued commitment shall include a20430
written report containing a current comprehensive evaluation and20431
assessment, a diagnosis, a prognosis, an account of progress and20432
past habilitation, and a description of alternative habilitation20433
settings and plans, including a habilitation setting that is the20434
least restrictive setting consistent with the need for20435
habilitation. A copy of the application shall be provided to20436
respondent's counsel. The requirements for notice under section20437
5123.73 of the Revised Code and the provisions of divisions (A) to20438
(E) of this section apply to all hearings on such applications.20439

       (2) A hearing on the first application for continued20440
commitment shall be held at the expiration of the first ninety-day20441
period. The hearing shall be mandatory and may not be waived.20442

       (3) Subsequent periods of commitment not to exceed one20443
hundred eighty days each may be ordered by the court if the20444
designee of the director of mental retardation and developmental20445
disabilities files an application for continued commitment, after20446
a hearing is held on the application or without a hearing if no20447
hearing is requested and no hearing required under division (H)(4)20448
of this section is waived. Upon the application of a person20449
involuntarily committed under this section, supported by an20450
affidavit of a licensed physician alleging that the person is no20451
longer a mentally retarded person subject to institutionalization20452
by court order, the court for good cause shown may hold a full20453
hearing on the person's continued commitment prior to the20454
expiration of any subsequent period of commitment set by the20455
court.20456

       (4) A mandatory hearing shall be held at least every two20457
years after the initial commitment.20458

       (5) If the court, after a hearing upon a request to continue20459
commitment, finds that the respondent is a mentally retarded20460
person subject to institutionalization by court order, the court20461
may make an order pursuant to divisions (C), (D), and (E) of this20462
section.20463

       (I) Notwithstanding the provisions of division (H) of this20464
section, no person who is found to be a mentally retarded person20465
subject to institutionalization by court order pursuant to20466
division (O)(N)(2) of section 5123.01 of the Revised Code shall be20467
held under involuntary commitment for more than five years.20468

       (J) The managing officer admitting a person pursuant to a20469
judicial proceeding, within ten working days of the admission,20470
shall make a report of the admission to the department.20471

       Sec. 5126.01.  As used in this chapter:20472

       (A) As used in this division, "adult" means an individual who 20473
is eighteen years of age or over and not enrolled in a program or 20474
service under Chapter 3323. of the Revised Code and an individual20475
sixteen or seventeen years of age who is eligible for adult 20476
services under rules adopted by the director of mental retardation 20477
and developmental disabilities pursuant to Chapter 119. of the20478
Revised Code.20479

       (1) "Adult services" means services provided to an adult20480
outside the home, except when they are provided within the home20481
according to an individual's assessed needs and identified in an20482
individual service plan, that support learning and assistance in20483
the area of self-care, sensory and motor development,20484
socialization, daily living skills, communication, community20485
living, social skills, or vocational skills.20486

       (2) "Adult services" includes all of the following:20487

       (a) Adult day habilitation services;20488

       (b) Adult day care;20489

       (c) Prevocational services;20490

       (d) Sheltered employment;20491

       (e) Educational experiences and training obtained through20492
entities and activities that are not expressly intended for20493
individuals with mental retardation and developmental20494
disabilities, including trade schools, vocational or technical20495
schools, adult education, job exploration and sampling, unpaid20496
work experience in the community, volunteer activities, and20497
spectator sports;20498

       (f) Community employment services and supported employment20499
services.20500

       (B)(1) "Adult day habilitation services" means adult services 20501
that do the following:20502

       (a) Provide access to and participation in typical activities 20503
and functions of community life that are desired and chosen by the 20504
general population, including such activities and functions as 20505
opportunities to experience and participate in community 20506
exploration, companionship with friends and peers, leisure 20507
activities, hobbies, maintaining family contacts, community 20508
events, and activities where individuals without disabilities are 20509
involved;20510

       (b) Provide supports or a combination of training and20511
supports that afford an individual a wide variety of opportunities20512
to facilitate and build relationships and social supports in the20513
community.20514

       (2) "Adult day habilitation services" includes all of the20515
following:20516

       (a) Personal care services needed to ensure an individual's20517
ability to experience and participate in vocational services,20518
educational services, community activities, and any other adult20519
day habilitation services;20520

       (b) Skilled services provided while receiving adult day20521
habilitation services, including such skilled services as behavior20522
management intervention, occupational therapy, speech and language20523
therapy, physical therapy, and nursing services;20524

       (c) Training and education in self-determination designed to20525
help the individual do one or more of the following: develop20526
self-advocacy skills, exercise the individual's civil rights,20527
acquire skills that enable the individual to exercise control and20528
responsibility over the services received, and acquire skills that20529
enable the individual to become more independent, integrated, or20530
productive in the community;20531

       (d) Recreational and leisure activities identified in the20532
individual's service plan as therapeutic in nature or assistive in20533
developing or maintaining social supports;20534

       (e) Counseling and assistance provided to obtain housing,20535
including such counseling as identifying options for either rental20536
or purchase, identifying financial resources, assessing needs for20537
environmental modifications, locating housing, and planning for20538
ongoing management and maintenance of the housing selected;20539

       (f) Transportation necessary to access adult day habilitation 20540
services;20541

       (g) Habilitation management, as described in section 5126.1420542
of the Revised Code.20543

       (3) "Adult day habilitation services" does not include20544
activities that are components of the provision of residential20545
services, family support services, or supported living services.20546

       (C) "Appointing authority" means the following:20547

       (1) In the case of a member of a county board of mental 20548
retardation and developmental disabilities appointed by, or to be 20549
appointed by, a board of county commissioners, the board of county 20550
commissioners;20551

       (2) In the case of a member of a county board appointed by, 20552
or to be appointed by, a senior probate judge, the senior probate 20553
judge.20554

       (D) "Community employment services" or "supported employment20555
services" means job training and other services related to20556
employment outside a sheltered workshop. "Community employment20557
services" or "supported employment services" include all of the20558
following:20559

       (1) Job training resulting in the attainment of competitive20560
work, supported work in a typical work environment, or20561
self-employment;20562

       (2) Supervised work experience through an employer paid to20563
provide the supervised work experience;20564

       (3) Ongoing work in a competitive work environment at a wage20565
commensurate with workers without disabilities;20566

       (4) Ongoing supervision by an employer paid to provide the20567
supervision.20568

       (E) As used in this division, "substantial functional20569
limitation," "developmental delay," and "established risk" have20570
the meanings established pursuant to section 5123.011 of the20571
Revised Code.20572

       "Developmental disability" means a severe, chronic disability20573
that is characterized by all of the following:20574

       (1) It is attributable to a mental or physical impairment or20575
a combination of mental and physical impairments, other than a20576
mental or physical impairment solely caused by mental illness as20577
defined in division (A) of section 5122.01 of the Revised Code;20578

       (2) It is manifested before age twenty-two;20579

       (3) It is likely to continue indefinitely;20580

       (4) It results in one of the following:20581

       (a) In the case of a person under age three, at least one20582
developmental delay or an established risk;20583

       (b) In the case of a person at least age three but under age20584
six, at least two developmental delays or an established risk;20585

       (c) In the case of a person age six or older, a substantial20586
functional limitation in at least three of the following areas of20587
major life activity, as appropriate for the person's age:20588
self-care, receptive and expressive language, learning, mobility,20589
self-direction, capacity for independent living, and, if the20590
person is at least age sixteen, capacity for economic20591
self-sufficiency.20592

       (5) It causes the person to need a combination and sequence20593
of special, interdisciplinary, or other type of care, treatment,20594
or provision of services for an extended period of time that is20595
individually planned and coordinated for the person.20596

       (F) "Early childhood services" means a planned program of20597
habilitation designed to meet the needs of individuals with mental20598
retardation or other developmental disabilities who have not20599
attained compulsory school age.20600

       (G)(1) "Environmental modifications" means the physical20601
adaptations to an individual's home, specified in the individual's20602
service plan, that are necessary to ensure the individual's20603
health, safety, and welfare or that enable the individual to20604
function with greater independence in the home, and without which20605
the individual would require institutionalization.20606

       (2) "Environmental modifications" includes such adaptations20607
as installation of ramps and grab-bars, widening of doorways,20608
modification of bathroom facilities, and installation of20609
specialized electric and plumbing systems necessary to accommodate20610
the individual's medical equipment and supplies.20611

       (3) "Environmental modifications" does not include physical20612
adaptations or improvements to the home that are of general20613
utility or not of direct medical or remedial benefit to the20614
individual, including such adaptations or improvements as20615
carpeting, roof repair, and central air conditioning.20616

       (H) "Family support services" means the services provided20617
under a family support services program operated under section20618
5126.11 of the Revised Code.20619

       (I) "Habilitation" means the process by which the staff of20620
the facility or agency assists an individual with mental20621
retardation or other developmental disability in acquiring and20622
maintaining those life skills that enable the individual to cope20623
more effectively with the demands of the individual's own person20624
and environment, and in raising the level of the individual's20625
personal, physical, mental, social, and vocational efficiency.20626
Habilitation includes, but is not limited to, programs of formal,20627
structured education and training.20628

       (J) "Home and community-based services" means medicaid-funded 20629
home and community-based services specified in division (B)(1) of 20630
section 5111.875163.65 of the Revised Code and provided under the20631
medicaid waiver components the department of mental retardation 20632
and developmental disabilities administers pursuant to section20633
5111.8715163.651 of the Revised Code.20634

       (K) "Immediate family" means parents, grandparents, brothers, 20635
sisters, spouses, sons, daughters, aunts, uncles, mothers-in-law, 20636
fathers-in-law, brothers-in-law, sisters-in-law, sons-in-law, and 20637
daughters-in-law.20638

       (L) "Medicaid" has the same meaning as in section 5111.01 of20639
the Revised Code.20640

       (M) "Medicaid case management services" means case management 20641
services provided to an individual with mental retardation or 20642
other developmental disability that the state medicaid plan 20643
requires.20644

       (N)(M) "Mental retardation" means a mental impairment20645
manifested during the developmental period characterized by20646
significantly subaverage general intellectual functioning existing20647
concurrently with deficiencies in the effectiveness or degree with20648
which an individual meets the standards of personal independence20649
and social responsibility expected of the individual's age and20650
cultural group.20651

       (O)(N) "Residential services" means services to individuals20652
with mental retardation or other developmental disabilities to20653
provide housing, food, clothing, habilitation, staff support, and20654
related support services necessary for the health, safety, and20655
welfare of the individuals and the advancement of their quality of20656
life. "Residential services" includes program management, as20657
described in section 5126.14 of the Revised Code.20658

       (P)(O) "Resources" means available capital and other assets,20659
including moneys received from the federal, state, and local20660
governments, private grants, and donations; appropriately20661
qualified personnel; and appropriate capital facilities and20662
equipment.20663

       (Q)(P) "Senior probate judge" means the current probate judge 20664
of a county who has served as probate judge of that county longer 20665
than any of the other current probate judges of that county. If a 20666
county has only one probate judge, "senior probate judge" means 20667
that probate judge.20668

       (R)(Q) "Service and support administration" means the duties20669
performed by a service and support administrator pursuant to20670
section 5126.15 of the Revised Code.20671

       (S)(R)(1) "Specialized medical, adaptive, and assistive20672
equipment, supplies, and supports" means equipment, supplies, and20673
supports that enable an individual to increase the ability to20674
perform activities of daily living or to perceive, control, or20675
communicate within the environment.20676

       (2) "Specialized medical, adaptive, and assistive equipment,20677
supplies, and supports" includes the following:20678

       (a) Eating utensils, adaptive feeding dishes, plate guards,20679
mylatex straps, hand splints, reaches, feeder seats, adjustable20680
pointer sticks, interpreter services, telecommunication devices20681
for the deaf, computerized communications boards, other20682
communication devices, support animals, veterinary care for20683
support animals, adaptive beds, supine boards, prone boards,20684
wedges, sand bags, sidelayers, bolsters, adaptive electrical20685
switches, hand-held shower heads, air conditioners, humidifiers,20686
emergency response systems, folding shopping carts, vehicle lifts,20687
vehicle hand controls, other adaptations of vehicles for20688
accessibility, and repair of the equipment received.20689

       (b) Nondisposable items not covered by medicaid that are20690
intended to assist an individual in activities of daily living or20691
instrumental activities of daily living.20692

       (T)(S) "Supportive home services" means a range of services20693
to families of individuals with mental retardation or other20694
developmental disabilities to develop and maintain increased20695
acceptance and understanding of such persons, increased ability of20696
family members to teach the person, better coordination between20697
school and home, skills in performing specific therapeutic and20698
management techniques, and ability to cope with specific20699
situations.20700

       (U)(T)(1) "Supported living" means services provided for as20701
long as twenty-four hours a day to an individual with mental20702
retardation or other developmental disability through any public20703
or private resources, including moneys from the individual, that20704
enhance the individual's reputation in community life and advance20705
the individual's quality of life by doing the following:20706

       (a) Providing the support necessary to enable an individual20707
to live in a residence of the individual's choice, with any number20708
of individuals who are not disabled, or with not more than three20709
individuals with mental retardation and developmental disabilities20710
unless the individuals are related by blood or marriage;20711

       (b) Encouraging the individual's participation in the20712
community;20713

       (c) Promoting the individual's rights and autonomy;20714

       (d) Assisting the individual in acquiring, retaining, and20715
improving the skills and competence necessary to live successfully20716
in the individual's residence.20717

       (2) "Supported living" includes the provision of all of the20718
following:20719

       (a) Housing, food, clothing, habilitation, staff support,20720
professional services, and any related support services necessary 20721
to ensure the health, safety, and welfare of the individual20722
receiving the services;20723

       (b) A combination of lifelong or extended-duration20724
supervision, training, and other services essential to daily20725
living, including assessment and evaluation and assistance with20726
the cost of training materials, transportation, fees, and20727
supplies;20728

       (c) Personal care services and homemaker services;20729

       (d) Household maintenance that does not include modifications 20730
to the physical structure of the residence;20731

       (e) Respite care services;20732

       (f) Program management, as described in section 5126.14 of20733
the Revised Code.20734

       Sec. 5126.042.  (A) As used in this section:20735

       (1) "Emergency" means any situation that creates for an20736
individual with mental retardation or developmental disabilities 20737
a risk of substantial self-harm or substantial harm to others if20738
action is not taken within thirty days. An "emergency" may include 20739
one or more of the following situations:20740

       (a) Loss of present residence for any reason, including legal20741
action;20742

       (b) Loss of present caretaker for any reason, including20743
serious illness of the caretaker, change in the caretaker's20744
status, or inability of the caretaker to perform effectively for20745
the individual;20746

       (c) Abuse, neglect, or exploitation of the individual;20747

       (d) Health and safety conditions that pose a serious risk to20748
the individual or others of immediate harm or death;20749

       (e) Change in the emotional or physical condition of the20750
individual that necessitates substantial accommodation that cannot20751
be reasonably provided by the individual's existing caretaker.20752

       (2) "Service substitution list" means a service substitution 20753
list established by a county board of mental retardation and 20754
developmental disabilities before the effective date of this 20755
amendmentSeptember 1, 2008, pursuant to division (B) of this 20756
section as this section existed on the day immediately before the 20757
effective date of this amendmentSeptember 1, 2008.20758

       (B) If a county board of mental retardation and developmental 20759
disabilities determines that available resources are not 20760
sufficient to meet the needs of all individuals who request20761
programs and services and may be offered the programs and20762
services, it shall establish waiting lists for services. The board 20763
may establish priorities for making placements on its waiting 20764
lists according to an individual's emergency status and shall 20765
establish priorities in accordance with divisions (D) and (E) of 20766
this section.20767

       The individuals who may be placed on a waiting list include20768
individuals with a need for services on an emergency basis and20769
individuals who have requested services for which resources are20770
not available.20771

       An individual placed on a county board's service substitution 20772
list before the effective date of this amendmentSeptember 1, 20773
2008, for the purpose of obtaining home and community-based 20774
services shall be deemed to have been placed on the county 20775
board's waiting list for home and community-based services on the 20776
date the individual made a request to the county board that the 20777
individual receive home and community-based services instead of 20778
the services the individual received at the time the request for 20779
home and community-based services was made to the county board.20780

       (C) A county board shall establish a separate waiting list20781
for each of the following categories of services, and may20782
establish separate waiting lists within the waiting lists:20783

       (1) Early childhood services;20784

       (2) Educational programs for preschool and school age20785
children;20786

       (3) Adult services;20787

       (4) Service and support administration;20788

       (5) Residential services and supported living;20789

       (6) Transportation services;20790

       (7) Other services determined necessary and appropriate for20791
persons with mental retardation or a developmental disability20792
according to their individual habilitation or service plans;20793

       (8) Family support services provided under section 5126.11 of 20794
the Revised Code.20795

       (D) Except as provided in division (G) of this section, a20796
county board shall do, as priorities, all of the following in20797
accordance with the assessment component, approved under section20798
5123.046 of the Revised Code, of the county board's plan developed20799
under section 5126.054 of the Revised Code:20800

       (1) For the purpose of obtaining additional federal medicaid20801
funds for home and community-based services and medicaid case20802
management services, do both of the following:20803

       (a) Give an individual who is eligible for home and20804
community-based services and meets both of the following20805
requirements priority over any other individual on a waiting list20806
established under division (C) of this section for home and20807
community-based services that include supported living,20808
residential services, or family support services:20809

       (i) Is twenty-two years of age or older;20810

       (ii) Receives supported living or family support services.20811

       (b) Give an individual who is eligible for home and20812
community-based services and meets both of the following20813
requirements priority over any other individual on a waiting list20814
established under division (C) of this section for home and20815
community-based services that include adult services:20816

       (i) Resides in the individual's own home or the home of the20817
individual's family and will continue to reside in that home after20818
enrollment in home and community-based services;20819

       (ii) Receives adult services from the county board.20820

       (2) As federal medicaid funds become available pursuant to20821
division (D)(1) of this section, give an individual who is20822
eligible for home and community-based services and meets any of20823
the following requirements priority for such services over any20824
other individual on a waiting list established under division (C)20825
of this section:20826

       (a) Does not receive residential services or supported20827
living, either needs services in the individual's current living20828
arrangement or will need services in a new living arrangement, and20829
has a primary caregiver who is sixty years of age or older;20830

       (b) Is less than twenty-two years of age and has at least one 20831
of the following service needs that are unusual in scope or20832
intensity:20833

       (i) Severe behavior problems for which a behavior support20834
plan is needed;20835

       (ii) An emotional disorder for which anti-psychotic20836
medication is needed;20837

       (iii) A medical condition that leaves the individual20838
dependent on life-support medical technology;20839

       (iv) A condition affecting multiple body systems for which a20840
combination of specialized medical, psychological, educational, or20841
habilitation services are needed;20842

       (v) A condition the county board determines to be comparable20843
in severity to any condition described in divisions (D)(2)(b)(i)20844
to (iv) of this section and places the individual at significant20845
risk of institutionalization.20846

       (c) Is twenty-two years of age or older, does not receive20847
residential services or supported living, and is determined by the20848
county board to have intensive needs for home and community-based20849
services on an in-home or out-of-home basis.20850

       (E) Except as provided in division (G) of this section and 20851
for a number of years and beginning on a date specified in rules 20852
adopted under division (K) of this section, a county board shall 20853
give an individual who is eligible for home and community-based 20854
services, resides in a nursing facility, and chooses to move to 20855
another setting with the help of home and community-based 20856
services, priority over any other individual on a waiting list 20857
established under division (C) of this section for home and 20858
community-based services who does not meet these criteria.20859

       (F) If two or more individuals on a waiting list established20860
under division (C) of this section for home and community-based20861
services have priority for the services pursuant to division20862
(D)(1) or (2) or (E) of this section, a county board may use 20863
criteria specified in rules adopted under division (K)(2) of this 20864
section in determining the order in which the individuals with 20865
priority will be offered the services. Otherwise, the county board 20866
shall offer the home and community-based services to such 20867
individuals in the order they are placed on the waiting list.20868

       (G) No individual may receive priority for services pursuant 20869
to division (D) or (E) of this section over an individual placed20870
on a waiting list established under division (C) of this section20871
on an emergency status.20872

       (H) Prior to establishing any waiting list under this20873
section, a county board shall develop and implement a policy for20874
waiting lists that complies with this section and rules adopted20875
under division (K) of this section.20876

       Prior to placing an individual on a waiting list, the county20877
board shall assess the service needs of the individual in20878
accordance with all applicable state and federal laws. The county20879
board shall place the individual on the appropriate waiting list20880
and may place the individual on more than one waiting list. The20881
county board shall notify the individual of the individual's20882
placement and position on each waiting list on which the20883
individual is placed.20884

       At least annually, the county board shall reassess the20885
service needs of each individual on a waiting list. If it20886
determines that an individual no longer needs a program or20887
service, the county board shall remove the individual from the20888
waiting list. If it determines that an individual needs a program20889
or service other than the one for which the individual is on the20890
waiting list, the county board shall provide the program or20891
service to the individual or place the individual on a waiting20892
list for the program or service in accordance with the board's20893
policy for waiting lists.20894

       When a program or service for which there is a waiting list20895
becomes available, the county board shall reassess the service20896
needs of the individual next scheduled on the waiting list to20897
receive that program or service. If the reassessment demonstrates20898
that the individual continues to need the program or service, the20899
board shall offer the program or service to the individual. If it20900
determines that an individual no longer needs a program or20901
service, the county board shall remove the individual from the20902
waiting list. If it determines that an individual needs a program20903
or service other than the one for which the individual is on the20904
waiting list, the county board shall provide the program or20905
service to the individual or place the individual on a waiting20906
list for the program or service in accordance with the board's20907
policy for waiting lists. The county board shall notify the20908
individual of the individual's placement and position on the20909
waiting list on which the individual is placed.20910

       (I) A child subject to a determination made pursuant to20911
section 121.38 of the Revised Code who requires the home and20912
community-based services provided through a medicaid component20913
that the department of mental retardation and developmental20914
disabilities administers under section 5111.8715163.651 of the20915
Revised Code shall receive services through that medicaid 20916
component. For all other services, a child subject to a20917
determination made pursuant to section 121.38 of the Revised Code20918
shall be treated as an emergency by the county boards and shall20919
not be subject to a waiting list.20920

       (J) Not later than the fifteenth day of March of each20921
even-numbered year, each county board shall prepare and submit to20922
the director of mental retardation and developmental disabilities20923
its recommendations for the funding of services for individuals20924
with mental retardation and developmental disabilities and its20925
proposals for reducing the waiting lists for services.20926

       (K)(1) The department of mental retardation and developmental20927
disabilities shall adopt rules in accordance with Chapter 119. of20928
the Revised Code governing waiting lists established under this20929
section. The rules shall include procedures to be followed to20930
ensure that the due process rights of individuals placed on20931
waiting lists are not violated.20932

       (2) As part of the rules adopted under this division, the20933
department shall adopt rules establishing criteria a county board 20934
may use under division (F) of this section in determining the 20935
order in which individuals with priority for home and 20936
community-based services will be offered the services. The rules 20937
shall also specify conditions under which a county board, when 20938
there is no individual with priority for home and community-based 20939
services pursuant to division (D)(1) or (2) or (E) of this section 20940
available and appropriate for the services, may offer the services 20941
to an individual on a waiting list for the services but not given 20942
such priority for the services. 20943

       (3) As part of the rules adopted under this division, the 20944
department shall adopt rules specifying both of the following for 20945
the priority category established under division (E) of this 20946
section:20947

        (a) The number of years, which shall not exceed five, that 20948
the priority category will be in effect;20949

        (b) The date that the priority category is to go into effect.20950

        (L) The following shall take precedence over the applicable20951
provisions of this section:20952

       (1) Medicaid rules and regulations;20953

       (2) Any specific requirements that may be contained within a20954
medicaid state plan amendment or waiver program that a county20955
board has authority to administer or with respect to which it has20956
authority to provide services, programs, or supports.20957

       Sec. 5126.046. (A) Each county board of mental retardation20958
and developmental disabilities that has medicaid local20959
administrative authority under division (A) of section 5126.055 of20960
the Revised Code for habilitation, vocational, or community20961
employment services provided as part of home and community-based20962
services shall create a list of all persons and government20963
entities eligible to provide such habilitation, vocational, or20964
community employment services. If the county board chooses and is20965
eligible to provide such habilitation, vocational, or community20966
employment services, the county board shall include itself on the20967
list. The county board shall make the list available to each20968
individual with mental retardation or other developmental20969
disability who resides in the county and is eligible for such20970
habilitation, vocational, or community employment services. The20971
county board shall also make the list available to such20972
individuals' families.20973

       An individual with mental retardation or other developmental20974
disability who is eligible for habilitation, vocational, or20975
community employment services may choose the provider of the20976
services.20977

       (B) Each month, the department of mental retardation and20978
developmental disabilities shall create a list of all persons and20979
government entities eligible to provide residential services and20980
supported living. The department shall include on the list all20981
residential facilities licensed under section 5123.19 of the20982
Revised Code and all supported living providers certified under20983
section 5123.161 of the Revised Code. The department shall20984
distribute the monthly lists to county boards that have local20985
administrative authority under division (A) of section 5126.055 20986
of the Revised Code for residential services and supported living20987
provided as part of home and community-based services. A county20988
board that receives a list shall make it available to each20989
individual with mental retardation or other developmental20990
disability who resides in the county and is eligible for such20991
residential services or supported living. The county board shall20992
also make the list available to the families of those 20993
individuals.20994

       An individual who is eligible for residential services or20995
supported living may choose the provider of the residential20996
services or supported living.20997

       (C) If a county board that has medicaid local administrative20998
authority under division (A) of section 5126.055 of the Revised20999
Code for home and community-based services violates the right21000
established by this section of an individual to choose a provider21001
that is qualified and willing to provide services to the21002
individual, the individual shall receive timely notice that the21003
individual may request a hearing under section 5101.355160.34 of 21004
the Revised Code.21005

       (D) The departments of mental retardation and developmental21006
disabilities and job and family serviceshealth care 21007
administration shall adopt rules in accordance with Chapter 119. 21008
of the Revised Code governing the implementation of this section. 21009
The rules shall include procedures for individuals to choose 21010
their service providers. The rules shall not be limited by a 21011
provider selection system established under section 5126.42 of 21012
the Revised Code, including any pool of providers created 21013
pursuant to a provider selection system.21014

       Sec. 5126.054.  (A) Each county board of mental retardation21015
and developmental disabilities shall, by resolution, develop a21016
three-calendar year plan that includes the following three21017
components:21018

       (1) An assessment component that includes all of the21019
following:21020

       (a) The number of individuals with mental retardation or21021
other developmental disability residing in the county who need the21022
level of care provided by an intermediate care facility for the21023
mentally retarded, may seek home and community-based services, are21024
given priority for the services pursuant to division (D) of21025
section 5126.042 of the Revised Code; the service needs of those21026
individuals; and the projected annualized cost for services;21027

       (b) The source of funds available to the county board to pay21028
the nonfederal share of medicaid expenditures that the county21029
board is required by sections 5126.059 and 5126.0510 of the21030
Revised Code to pay;21031

       (c) Any other applicable information or conditions that the21032
department of mental retardation and developmental disabilities21033
requires as a condition of approving the component under section21034
5123.046 of the Revised Code.21035

       (2) (A preliminary implementation component that specifies 21036
the number of individuals to be provided, during the first year 21037
that the plan is in effect, home and community-based services 21038
pursuant to the priority given to them under divisions (D)(1) and 21039
(2) of section 5126.042 of the Revised Code and the types of home 21040
and community-based services the individuals are to receive;21041

       (3) A component that provides for the implementation of 21042
medicaid case management services and home and community-based 21043
services for individuals who begin to receive the services on or 21044
after the date the plan is approved under section 5123.046 of the 21045
Revised Code. A county board shall include all of the following in 21046
the component:21047

       (a) If the department of mental retardation and developmental 21048
disabilities or department of job and family serviceshealth care 21049
administration requires, an agreement to pay the nonfederal share 21050
of medicaid expenditures that the county board is required by 21051
sections 5126.059 and 5126.0510 of the Revised Code to pay;21052

       (b) How the services are to be phased in over the period the21053
plan covers, including how the county board will serve individuals21054
on a waiting list established under division (C) of section21055
5126.042 who are given priority status under division (D)(1) of21056
that section;21057

       (c) Any agreement or commitment regarding the county board's21058
funding of home and community-based services that the county board21059
has with the department at the time the county board develops the21060
component;21061

       (d) Assurances adequate to the department that the county21062
board will comply with all of the following requirements:21063

       (i) To provide the types of home and community-based services21064
specified in the preliminary implementation component required by21065
division (A)(2) of this section to at least the number of21066
individuals specified in that component;21067

       (ii) To use any additional funds the county board receives21068
for the services to improve the county board's resource21069
capabilities for supporting such services available in the county21070
at the time the component is developed and to expand the services21071
to accommodate the unmet need for those services in the county;21072

       (iii) To employ a business manager who is either a new21073
employee who has earned at least a bachelor's degree in business21074
administration or a current employee who has the equivalent21075
experience of a bachelor's degree in business administration. If21076
the county board will employ a new employee, the county board21077
shall include in the component a timeline for employing the21078
employee.21079

       (iv) To employ or contract with a medicaid services manager21080
who is either a new employee who has earned at least a bachelor's21081
degree or a current employee who has the equivalent experience of21082
a bachelor's degree. If the county board will employ a new21083
employee, the county board shall include in the component a21084
timeline for employing the employee. Two or three county boards21085
that have a combined total enrollment in county board services not21086
exceeding one thousand individuals as determined pursuant to21087
certifications made under division (B) of section 5126.12 of the21088
Revised Code may satisfy this requirement by sharing the services21089
of a medicaid services manager or using the services of a medicaid21090
services manager employed by or under contract with a regional21091
council that the county boards establish under section 5126.13 of21092
the Revised Code.21093

       (e) Programmatic and financial accountability measures and21094
projected outcomes expected from the implementation of the plan;21095

       (f) Any other applicable information or conditions that the21096
department requires as a condition of approving the component21097
under section 5123.046 of the Revised Code.21098

       (B) A county board whose plan developed under division (A) of 21099
this section is approved by the department under section 5123.046 21100
of the Revised Code shall update and renew the plan in accordance 21101
with a schedule the department shall develop.21102

       Sec. 5126.055.  (A) Except as provided in section 5126.056 21103
of the Revised Code, a county board of mental retardation and21104
developmental disabilities has medicaid local administrative21105
authority to, and shall, do all of the following for an individual21106
with mental retardation or other developmental disability who21107
resides in the county that the county board serves and seeks or21108
receives home and community-based services:21109

       (1) Perform assessments and evaluations of the individual. As 21110
part of the assessment and evaluation process, the county board21111
shall do all of the following:21112

       (a) Make a recommendation to the department of mental21113
retardation and developmental disabilities on whether the21114
department should approve or deny the individual's application for21115
the services, including on the basis of whether the individual21116
needs the level of care an intermediate care facility for the21117
mentally retarded provides;21118

       (b) If the individual's application is denied because of the21119
county board's recommendation and the individual requests a21120
hearing under section 5101.355160.34 of the Revised Code, 21121
present, with the department of mental retardation and 21122
developmental disabilities or department of job and family 21123
serviceshealth care administration, whichever denies the 21124
application, the reasons for the recommendation and denial at the 21125
hearing;21126

       (c) If the individual's application is approved, recommend to 21127
the departments of mental retardation and developmental21128
disabilities and job and family serviceshealth care 21129
administration the services that should be included in the 21130
individual's individualized service plan and, if either department 21131
approves, reduces, denies, or terminates a service included in the 21132
individual's individualized service plan under section 5111.87121133
5163.651 of the Revised Code because of the county board's21134
recommendation, present, with the department that made the21135
approval, reduction, denial, or termination, the reasons for the21136
recommendation and approval, reduction, denial, or termination at21137
a hearing under section 5101.355160.34 of the Revised Code.21138

       (2) In accordance with the rules adopted under section21139
5126.046 of the Revised Code, perform the county board's duties21140
under that section regarding assisting the individual's right to21141
choose a qualified and willing provider of the services and, at a21142
hearing under section 5101.35 of the Revised Code, present21143
evidence of the process for appropriate assistance in choosing21144
providers;21145

       (3) If the county board is certified under section 5123.161 21146
of the Revised Code to provide the services and agrees to21147
provide the services to the individual and the individual 21148
chooses the county board to provide the services, furnish, in 21149
accordance with the county board's medicaid provider agreement 21150
and for the authorized reimbursement rate, the services the 21151
individual requires;21152

       (4) Monitor the services provided to the individual and21153
ensure the individual's health, safety, and welfare. The21154
monitoring shall include quality assurance activities. If the21155
county board provides the services, the department of mental21156
retardation and developmental disabilities shall also monitor the21157
services.21158

       (5) Develop, with the individual and the provider of the21159
individual's services, an effective individualized service plan21160
that includes coordination of services, recommend that the21161
departments of mental retardation and developmental disabilities21162
and job and family serviceshealth care administration approve the 21163
plan, and implement the plan unless either department disapproves 21164
it;21165

       (6) Have an investigative agent conduct investigations under21166
section 5126.313 of the Revised Code that concern the individual;21167

       (7) Have a service and support administrator perform the21168
duties under division (B)(9) of section 5126.15 of the Revised21169
Code that concern the individual.21170

       (B) A county board shall perform its medicaid local21171
administrative authority under this section in accordance with all21172
of the following:21173

       (1) The county board's plan that the department of mental21174
retardation and developmental disabilities approves under section21175
5123.046 of the Revised Code;21176

       (2) All applicable federal and state laws;21177

       (3) All applicable policies of the departments of mental21178
retardation and developmental disabilities and job and family21179
serviceshealth care administration and the United States 21180
department of health and human services;21181

       (4) The department of job and family services'health care 21182
administration's supervision under its authority under section 21183
5111.015161.01 of the Revised Code to act as the single state 21184
medicaid agency;21185

       (5) The department of mental retardation and developmental21186
disabilities' oversight.21187

       (C) The departments of mental retardation and developmental21188
disabilities and job and family serviceshealth care 21189
administration shall communicate with and provide training to 21190
county boards regarding medicaid local administrative authority 21191
granted by this section. The communication and training shall 21192
include issues regarding audit protocols and other standards 21193
established by the United States department of health and human 21194
services that the departments determine appropriate for 21195
communication and training. County boards shall participate in the 21196
training. The departments shall assess the county board's 21197
compliance against uniform standards that the departments shall 21198
establish.21199

       (D) A county board may not delegate its medicaid local21200
administrative authority granted under this section but may21201
contract with a person or government entity, including a council21202
of governments, for assistance with its medicaid local21203
administrative authority. A county board that enters into such a21204
contract shall notify the director of mental retardation and21205
developmental disabilities. The notice shall include the tasks and21206
responsibilities that the contract gives to the person or21207
government entity. The person or government entity shall comply in 21208
full with all requirements to which the county board is subject21209
regarding the person or government entity's tasks and21210
responsibilities under the contract. The county board remains21211
ultimately responsible for the tasks and responsibilities.21212

       (E) A county board that has medicaid local administrative21213
authority under this section shall, through the departments of21214
mental retardation and developmental disabilities and job and21215
family serviceshealth care administration, reply to, and 21216
cooperate in arranging compliance with, a program or fiscal audit 21217
or program violation exception that a state or federal audit or 21218
review discovers. The department of job and family serviceshealth 21219
care administration shall timely notify the department of mental21220
retardation and developmental disabilities and the county board of21221
any adverse findings. After receiving the notice, the county21222
board, in conjunction with the department of mental retardation21223
and developmental disabilities, shall cooperate fully with the21224
department of job and family serviceshealth care administration21225
and timely prepare and send to the department a written plan of 21226
correction or response to the adverse findings. The county board 21227
is liable for any adverse findings that result from an action it 21228
takes or fails to take in its implementation of medicaid local 21229
administrative authority.21230

       (F) If the department of mental retardation and developmental 21231
disabilities or department of job and family serviceshealth care 21232
administration determines that a county board's implementation of 21233
its medicaid local administrative authority under this section is21234
deficient, the department that makes the determination shall21235
require that county board do the following:21236

       (1) If the deficiency affects the health, safety, or welfare21237
of an individual with mental retardation or other developmental21238
disability, correct the deficiency within twenty-four hours;21239

       (2) If the deficiency does not affect the health, safety, or21240
welfare of an individual with mental retardation or other21241
developmental disability, receive technical assistance from the21242
department or submit a plan of correction to the department that21243
is acceptable to the department within sixty days and correct the21244
deficiency within the time required by the plan of correction.21245

       Sec. 5126.0512.  (A) As used in this section, "medicaid 21246
waiver component" means a medicaid waiver component as defined in 21247
section 5111.855163.50 of the Revised Code under which home and 21248
community-based services are provided.21249

       (B) Effective July 1, 2007, each county board of mental 21250
retardation and developmental disabilities shall ensure, for each 21251
medicaid waiver component, that the number of individuals eligible 21252
under section 5126.041 of the Revised Code for services from the 21253
county board who are enrolled in a medicaid waiver component is no 21254
less than the sum of the following:21255

       (1) The number of individuals eligible for services from the 21256
county board who are enrolled in the medicaid waiver component on 21257
June 30, 2007;21258

       (2) The number of medicaid waiver component slots the county 21259
board requested before July 1, 2007, that were assigned to the 21260
county board before that date but in which no individual was 21261
enrolled before that date.21262

       (C) An individual enrolled in a medicaid waiver component 21263
after March 1, 2007, due to an emergency reserve capacity waiver 21264
assignment shall not be counted in determining the number of 21265
individuals a county board must ensure under division (B) of this 21266
section are enrolled in a medicaid waiver component.21267

       (D) An individual who is enrolled in a medicaid waiver 21268
component to comply with the terms of the consent order filed 21269
March 5, 2007, in Martin v. Strickland, Case No. 89-CV-00362, in 21270
the United States district court for the southern district of 21271
Ohio, eastern division, shall be excluded in determining whether a 21272
county board has complied with division (B) of this section.21273

       (E) A county board shall make as many requests for 21274
individuals to be enrolled in a medicaid waiver component as 21275
necessary for the county board to comply with division (B) of this 21276
section.21277

       Sec. 5126.082.  (A) In addition to the rules adopted under 21278
division (A)(2) of section 5126.08 of the Revised Code 21279
establishing standards to be followed by county boards of mental 21280
retardation and developmental disabilities in administering, 21281
providing, arranging, and operating programs and services and in 21282
addition to the board accreditation system established under 21283
section 5126.081 of the Revised Code, the director of mental21284
retardation and developmental disabilities shall adopt rules in21285
accordance with Chapter 119. of the Revised Code establishing 21286
standards for promoting and advancing the quality of life of 21287
individuals with mental retardation and developmental disabilities 21288
receiving any of the following:21289

       (1) Early childhood services pursuant to section 5126.05 of 21290
the Revised Code for children under age three;21291

       (2) Adult services pursuant to section 5126.05 and division 21292
(B) of section 5126.051 of the Revised Code for individuals age21293
sixteen or older;21294

       (3) Family support services pursuant to section 5126.11 of 21295
the Revised Code.21296

       (B) The rules adopted under this section shall specify the 21297
actions county boards of mental retardation and developmental 21298
disabilities and the agencies with which they contract should take 21299
to do the following:21300

       (1) Offer individuals with mental retardation and21301
developmental disabilities, and their families when appropriate,21302
choices in programs and services that are centered on the needs21303
and desires of those individuals;21304

       (2) Maintain infants with their families whenever possible by 21305
collaborating with other agencies that provide services to infants 21306
and their families and taking other appropriate actions;21307

       (3) Provide families that have children with mental21308
retardation and developmental disabilities under age eighteen21309
residing in their homes the resources necessary to allow the21310
children to remain in their homes;21311

       (4) Create and implement community employment services based 21312
on the needs and desires of adults with mental retardation and 21313
developmental disabilities;21314

       (5) Create, in collaboration with other agencies,21315
transportation systems that provide safe and accessible21316
transportation within the county to individuals with disabilities;21317

       (6) Provide services that allow individuals with disabilities 21318
to be integrated into the community by engaging in educational, 21319
vocational, and recreational activities with individuals who do 21320
not have disabilities;21321

       (7) Provide age-appropriate retirement services for21322
individuals age sixty-five and older with mental retardation and21323
developmental disabilities;21324

       (8) Establish residential services and supported living for 21325
individuals with mental retardation and developmental disabilities 21326
in accordance with their needs.21327

       (C) To assist in funding programs and services that meet the 21328
standards established under this section, each county board of 21329
mental retardation and developmental disabilities shall make a 21330
good faith effort to acquire available federal funds, including 21331
reimbursements under Title XIX of the "Social Security Act," 79 21332
Stat. 286 (1965), 42 U.S.C.A. 1396, as amendedmedicaid program.21333

       (D) Each county board of mental retardation and developmental 21334
disabilities shall work toward full compliance with the standards 21335
established under this section, based on its available resources. 21336
Funds received under this chapter shall be used to comply with the 21337
standards. Annually, each board shall conduct a self audit to 21338
evaluate the board's progress in complying fully with the 21339
standards.21340

       (E) The department shall complete a program quality review of 21341
each county board of mental retardation and developmental 21342
disabilities to determine the extent to which the board has 21343
complied with the standards. The review shall be conducted in 21344
conjunction with the comprehensive accreditation review of the 21345
board that is conducted under section 5126.081 of the Revised 21346
Code.21347

       Notwithstanding any provision of this chapter or Chapter 21348
5123. of the Revised Code requiring the department to distribute 21349
funds to county boards of mental retardation and developmental 21350
disabilities, the department may withhold funds from a board if it 21351
finds that the board is not in substantial compliance with the 21352
standards established under this section.21353

       (F) When the standards for accreditation from the commission 21354
on accreditation of rehabilitation facilities, or another 21355
accrediting agency, meet or exceed the standards established under 21356
this section, the director may accept accreditation from the 21357
commission or other agency as evidence that the board is in 21358
compliance with all or part of the standards established under 21359
this section. Programs and services accredited by the commission 21360
or agency are exempt from the program quality reviews required by 21361
division (E) of this section.21362

       Sec. 5126.12.  (A) As used in this section:21363

       (1) "Approved school age class" means a class operated by a21364
county board of mental retardation and developmental disabilities21365
and funded by the department of education under section 3317.20 of 21366
the Revised Code.21367

       (2) "Approved preschool unit" means a class or unit operated21368
by a county board of mental retardation and developmental21369
disabilities and approved under division (B) of section 3317.05 of 21370
the Revised Code.21371

       (3) "Active treatment" means a continuous treatment program,21372
which includes aggressive, consistent implementation of a program21373
of specialized and generic training, treatment, health services,21374
and related services, that is directed toward the acquisition of21375
behaviors necessary for an individual with mental retardation or21376
other developmental disability to function with as much21377
self-determination and independence as possible and toward the21378
prevention of deceleration, regression, or loss of current optimal21379
functional status.21380

       (4) "Eligible for active treatment" means that an individual21381
with mental retardation or other developmental disability resides21382
in an intermediate care facility for the mentally retarded21383
certified under Title XIX of the "Social Security Act," 79 Stat. 21384
286 (1965), 42 U.S.C. 1396, as amendedfor the medicaid program; 21385
resides in a state institution operated by the department of 21386
mental retardation and developmental disabilities; or is enrolled 21387
in home and community-based services.21388

       (5) "Traditional adult services" means vocational and21389
nonvocational activities conducted within a sheltered workshop or21390
adult activity center or supportive home services.21391

       (B) Each county board of mental retardation and developmental 21392
disabilities shall certify to the director of mental retardation 21393
and developmental disabilities all of the following:21394

       (1) On or before the fifteenth day of October, the average21395
daily membership for the first full week of programs and services21396
during October receiving:21397

       (a) Early childhood services provided pursuant to section21398
5126.05 of the Revised Code for children who are less than three21399
years of age on the thirtieth day of September of the academic21400
year;21401

       (b) Special education for children with disabilities in 21402
approved school age classes;21403

       (c) Adult services for persons sixteen years of age and older 21404
operated pursuant to section 5126.05 and division (B) of section 21405
5126.051 of the Revised Code. Separate counts shall be made for21406
the following:21407

       (i) Persons enrolled in traditional adult services who are21408
eligible for but not enrolled in active treatment;21409

       (ii) Persons enrolled in traditional adult services who are21410
eligible for and enrolled in active treatment;21411

       (iii) Persons enrolled in traditional adult services but who21412
are not eligible for active treatment;21413

       (iv) Persons participating in community employment services.21414
To be counted as participating in community employment services, a21415
person must have spent an average of no less than ten hours per21416
week in that employment during the preceding six months.21417

       (d) Other programs in the county for individuals with mental21418
retardation and developmental disabilities that have been approved21419
for payment of subsidy by the department of mental retardation and21420
developmental disabilities.21421

       The membership in each such program and service in the county21422
shall be reported on forms prescribed by the department of mental21423
retardation and developmental disabilities.21424

       The department of mental retardation and developmental21425
disabilities shall adopt rules defining full-time equivalent21426
enrollees and for determining the average daily membership21427
therefrom, except that certification of average daily membership21428
in approved school age classes shall be in accordance with rules21429
adopted by the state board of education. The average daily21430
membership figure shall be determined by dividing the amount21431
representing the sum of the number of enrollees in each program or21432
service in the week for which the certification is made by the21433
number of days the program or service was offered in that week. No21434
enrollee may be counted in average daily membership for more than21435
one program or service.21436

       (2) By the fifteenth day of December, the number of children21437
enrolled in approved preschool units on the first day of December;21438

       (3) On or before the thirtieth day of April, an itemized21439
report of all income and operating expenditures for the21440
immediately preceding calendar year, in the format specified by21441
the department of mental retardation and developmental21442
disabilities;21443

       (4) That each required certification and report is in21444
accordance with rules established by the department of mental21445
retardation and developmental disabilities and the state board of21446
education for the operation and subsidization of the programs and21447
services.21448

       Sec. 5160.01.  As used in the Revised Code:21449

       "Children's buy-in program" means the program established 21450
under sections 5167.35 to 5167.40 of the Revised Code.21451

       "Children's health insurance program" means the program 21452
authorized by Title XXI of the Social Security Act of 1935 and 21453
sections 5167.01 to 5167.32 of the Revised Code.21454

       "Disability medical assistance program" and "disability 21455
medical assistance" mean the program authorized by Chapter 5168. 21456
of the Revised Code.21457

       "Medicaid program" and "medicaid" mean the medical assistance 21458
program created by Title XIX of the Social Security Act of 1935 21459
and Chapters 5161., 5162., 5163., 5164., 5165., and 5166. of the 21460
Revised Code.21461

       "Medicare program" and "medicare" mean the health insurance 21462
program created by Title XVIII of the Social Security Act of 1935.21463

       "Ohio's best Rx program" means the program established under 21464
Chapter 5169. of the Revised Code.21465

       "Supplemental security income program," "SSI program," 21466
"supplemental security income," and "SSI" mean the program 21467
providing benefits to qualified aged, blind, and disabled 21468
individuals created by Title XVI of the Social Security Act of 21469
1935.21470

       "Residential state supplement program" means the program 21471
administered pursuant to section 5160.80 of the Revised Code.21472

       Sec. 5160.02.  As used in this chapter:21473

       (A) "ODHCA family services duty" means a family services duty 21474
associated with an ODHCA program.21475

       (B) "ODHCA program" means all of the following:21476

       (1) The children's buy-in program;21477

       (2) The children's health insurance program;21478

       (3) The disability medical assistance program;21479

       (4) The medicaid program;21480

       (5) The Ohio's best Rx program;21481

       (6) The residential state supplement program;21482

       (7) Any other program that state law permits or requires the 21483
department of health care administration to administer.21484

       Sec. 5160.03. The director of health care administration 21485
shall do all of the following as necessary for the department's 21486
efficient administration:21487

       (A) Organize the department of health care administration, 21488
including creating administrative subunits;21489

       (B) Appoint employees and prescribe their titles and duties, 21490
including chiefs of administrative subunits;21491

       (C) Establish procedures for conducting the business of the 21492
department, including procedures for the custody, use, and 21493
preservation of records, papers, documents, and property.21494

       Sec. 5111.084.        Sec. 5160.04.  There is hereby established the 21495
pharmacy and therapeutics committee of the department of job and 21496
family serviceshealth care administration. The committee shall 21497
consist of ten members and shall be appointed by the director of 21498
job and family serviceshealth care administration. The21499
membership of the committee shall include:21500

       (A) Three pharmacists licensed under Chapter 4729. of the 21501
Revised Code;21502

       (B) Two doctors of medicine and two doctors of osteopathy 21503
who hold certificates issued under Chapter 4731. of the Revised 21504
Code;21505

       (C) A registered nurse licensed under Chapter 4723. of the 21506
Revised Code;21507

       (D) A pharmacologist who has a doctoral degree;21508

       (E) A psychiatrist who holds a certificate issued under 21509
Chapter 4731. of the Revised Code and specializes in psychiatry.21510

       The committee shall elect one of its members as chairperson.21511

       Sec. 5160.05. If the director of health care administration 21512
determines that a position with the department of health care 21513
administration can best be filled in accordance with division 21514
(A)(2) of section 124.30 of the Revised Code or without regard to 21515
a residency requirement established by a rule adopted by the 21516
director of administrative services, the director of health care 21517
administration shall provide the director of administrative 21518
services certification of the determination.21519

       Sec. 5160.06. The director of health care administration may 21520
require any of the employees of the department of health care 21521
administration who may be charged with custody or control of any 21522
public money or property or who is required to give bond, to give 21523
a bond, properly conditioned, in a sum to be fixed by the director 21524
which when approved by the director, shall be filed in the office 21525
of the secretary of state. The cost of such bonds, when approved 21526
by the director, shall be paid from funds available for the 21527
department. The bonds required or authorized by this section may, 21528
in the discretion of the director, be individual, schedule, or 21529
blanket bonds.21530

       Sec. 5160.08. The director of health care administration may 21531
acquire by purchase, lease, or otherwise such real and personal 21532
property rights in the name of the state as are necessary for the 21533
purposes of the department of health care administration. The 21534
director, with the approval of the governor and the attorney 21535
general, may sell, lease, or exchange portions of real and 21536
personal property of the department when the sale, lease, or 21537
exchange is advantageous to the state. Money received from such 21538
sales, leases, or exchanges shall be credited to the general 21539
revenue fund.21540

       Sec. 5160.10. There is hereby created in the state treasury 21541
the ODHCA support services federal operating fund. The fund shall 21542
consist of federal funds the department of health care 21543
administration receives and that the director of health care 21544
administration determines are appropriate for deposit into the 21545
fund. Money in the fund shall be used to pay the federal share of 21546
both of the following:21547

       (A) The department's costs for computer projects;21548

       (B) The operating costs of the parts of the department that 21549
provide general support services for the department's 21550
administrative subunits.21551

       Sec. 5160.101. There is hereby created in the state treasury 21552
the ODHCA support services state operating fund. The fund shall 21553
consist of payments made to the fund from other appropriation 21554
items by intrastate transfer voucher. Money in the fund shall be 21555
used to pay for both of the following:21556

       (A) The department of health care administration's costs for 21557
computer projects;21558

       (B) The operating costs of the parts of the department that 21559
provide general support services for the department's 21560
administrative subunits.21561

       Sec. 5160.12. The director of health care administration may 21562
expend funds appropriated or available to the department of health 21563
care administration from any person or government entity. For 21564
purposes of this section, the director may enter into contracts 21565
with persons and government entities and make grants to persons 21566
and government entities. To the extent permitted by federal law, 21567
the director may advance funds to a grantee when necessary for the 21568
grantee to perform duties under the grant as specified by the 21569
director.21570

       Sec. 5160.13. (A) As used in this section:21571

       (1) "Entity" includes an agency, board, commission, or 21572
department of the state or a political subdivision of the state; a 21573
private, nonprofit entity; a school district; a private school; or 21574
a public or private institution of higher education.21575

       (2) "Federal financial participation" means the federal 21576
government's share of expenditures made by an entity in 21577
implementing an ODHCA program.21578

       (B) This section does not apply to contracts entered into 21579
under section 5161.05 or 5161.10 of the Revised Code.21580

       (C) At the request of any public entity having authority to 21581
implement an ODHCA program or any private entity under contract 21582
with a public entity to implement an ODHCA program, the department 21583
may seek to obtain federal financial participation for costs 21584
incurred by the entity. Federal financial participation may be 21585
sought only for expenditures made with funds for which federal 21586
financial participation is available under federal law.21587

       (D) All funds collected by the department pursuant to this 21588
section shall be distributed to the entities that incurred the 21589
costs, except for any amounts retained by the department pursuant 21590
to division (E)(3) of this section.21591

       (E) In distributing federal financial participation pursuant 21592
to this section, the department may either enter into an agreement 21593
with the entity that is to receive the funds or distribute the 21594
funds in accordance with rules adopted under division (F) of this 21595
section. If the department decides to enter into an agreement to 21596
distribute the funds, the agreement may include terms that do any 21597
of the following:21598

       (1) Provide for the whole or partial reimbursement of any 21599
cost incurred by the entity in implementing the program;21600

       (2) In the event that federal financial participation is 21601
disallowed or otherwise unavailable for any expenditure, require 21602
the department or the entity, whichever party caused the 21603
disallowance or unavailability of federal financial participation, 21604
to assume responsibility for the expenditures;21605

       (3) Permit the department to retain not more than five per 21606
cent of the amount of the federal financial participation to be 21607
distributed to the entity;21608

       (4) Require the public entity to certify the availability of 21609
sufficient unencumbered funds to match the federal financial 21610
participation it receives under this section;21611

       (5) Establish the length of the agreement, which may be for a 21612
fixed or a continuing period of time;21613

       (6) Establish any other requirements determined by the 21614
department to be necessary for the efficient administration of the 21615
agreement.21616

       (F) The director of health care administration shall adopt 21617
rules as necessary to implement this section, including rules for 21618
the distribution of federal financial participation pursuant to 21619
this section. The rules shall be adopted in accordance with 21620
Chapter 119. of the Revised Code. The director may amend the state 21621
medicaid plan or state child health plan as necessary to implement 21622
this section.21623

       (G) Federal financial participation received pursuant to this 21624
section shall not be included in any calculation made under 21625
sections 5160.26 and 5160.261 of the Revised Code.21626

       Sec. 5160.15.  (A) As used in sections 5160.15 to 5160.152 of 21627
the Revised Code:21628

       (1) "County subgrant" means a grant that a board of county 21629
commissioners awards to another entity.21630

       (2) "County subgrant agreement" means an agreement between a 21631
board of county commissioners and another entity under which the 21632
board awards the other entity one or more county subgrants.21633

       (3) "Fiscal biennial period" means a two-year period 21634
beginning on the first day of July of an odd-numbered year and 21635
ending on the last day of June of the next odd-numbered year.21636

       (4) "Grant" means an award for one or more ODHCA family 21637
services duties of federal financial assistance that a federal 21638
agency provides in the form of money, or property in lieu of 21639
money, to the department of health care administration and that 21640
the department awards to a board of county commissioners. "Grant" 21641
may include state funds the department awards to a board of county 21642
commissioners to match the federal financial assistance. "Grant" 21643
does not mean either of the following:21644

       (a) Technical assistance that provides services instead of 21645
money;21646

       (b) Other assistance provided in the form of revenue sharing, 21647
loans, loan guarantees, interest subsidies, or insurance.21648

       (5) "Grant agreement" means an agreement between the 21649
department of health care administration and a board of county 21650
commissioners under which the department awards the board one or 21651
more grants.21652

       (B) Effective July 1, 2009, the director of health care 21653
administration may award grants to counties only through grant 21654
agreements entered into under this section.21655

       (C) The director shall enter into one or more written grant 21656
agreements with the board of county commissioners of each county. 21657
Except as provided in rules adopted under this section, grant 21658
agreements shall be entered into before the first day of each 21659
fiscal biennial period and shall be in effect for that fiscal 21660
biennial period or, in the case of a grant agreement entered into 21661
after the first day of a fiscal biennial period and except as 21662
provided by section 5160.151 of the Revised Code, for the 21663
remainder of the fiscal biennial period. A grant agreement shall 21664
do all of the following:21665

       (1) Comply with all of the conditions, requirements, and 21666
restrictions applicable to the ODHCA family services duties for 21667
which the grants included in the agreement are awarded, including 21668
the conditions, requirements, and restrictions established by the 21669
department, federal or state law, state plans for receipt of 21670
federal financial participation, agreements between the department 21671
and a federal agency, and executive orders issued by the governor;21672

       (2) Establish terms and conditions governing the 21673
accountability for and use of the grants included in the grant 21674
agreement;21675

       (3) Specify both of the following:21676

       (a) The ODHCA family services duties for which the grants 21677
included in the agreement are awarded;21678

       (b) The private and government entities designated under 21679
section 307.981 of the Revised Code to serve as the county family 21680
services agencies performing the ODHCA family services duties.21681

       (4) Provide for the department of health care administration 21682
to award the grants included in the agreement in accordance with a 21683
methodology for determining the amount of the award established by 21684
rules adopted under this section;21685

       (5) Specify the form of the grants which may be a cash draw, 21686
reimbursement, property, advance, working capital advance, or 21687
other forms specified in rules adopted under this section;21688

       (6) Provide that the grants are subject to the availability 21689
of federal funds and appropriations made by the general assembly;21690

       (7) Specify annual financial, administrative, or other 21691
incentive awards, if any, to be provided in accordance with 21692
section 5160.20 of the Revised Code;21693

       (8) Include the assurance of each board of county 21694
commissioners that the board will do all of the following:21695

       (a) Ensure that the grants included in the agreement are 21696
used, and the ODHCA family services duties for which the grants 21697
are awarded are performed, in accordance with conditions, 21698
requirements, and restrictions applicable to the duties 21699
established by the department, a federal or state law, state plans 21700
for receipt of federal financial participation, agreements between 21701
the department and a federal agency, and executive orders issued 21702
by the governor;21703

       (b) Utilize a financial management system and other 21704
accountability mechanisms for the grants awarded under the 21705
agreement that meet requirements the department establishes;21706

       (c) Do all of the following with regard to a county subgrant:21707

       (i) Award the subgrant through a written county subgrant 21708
agreement that requires the entity awarded the county subgrant to 21709
comply with all conditions, requirements, and restrictions 21710
applicable to the board of county commissioners regarding the 21711
grant that the board subgrants to the entity, including the 21712
conditions, requirements, and restrictions of this section;21713

       (ii) Monitor the entity that is awarded the subgrant to 21714
ensure that the entity uses the subgrant in accordance with 21715
conditions, requirements, and restrictions applicable to the ODHCA 21716
family services duties for which the subgrant is awarded;21717

       (iii) Take action to recover subgrants that are not used in 21718
accordance with the conditions, requirements, or restrictions 21719
applicable to the ODHCA family services duties for which the 21720
subgrant is awarded.21721

       (d) Promptly reimburse the department the amount that 21722
represents the amount the board of county commissioners is 21723
responsible for, pursuant to action the department takes under 21724
division (B) of section 5160.21 of the Revised Code, of funds the 21725
department pays to any entity because of an adverse audit finding, 21726
adverse quality control finding, final disallowance of federal 21727
financial participation, or other sanction or penalty;21728

       (e) Take prompt corrective action, including paying amounts 21729
resulting from an adverse finding, sanction, or penalty, if the 21730
department, auditor of state, federal agency, or other entity 21731
authorized by federal or state law to determine compliance with 21732
the conditions, requirements, and restrictions applicable to an 21733
ODHCA family services duty for which a grant included in the 21734
agreement is awarded determines compliance has not been achieved;21735

       (f) Ensure that any matching funds, regardless of the source, 21736
that the board of county commissioners manages are clearly 21737
identified and used in accordance with federal and state laws and 21738
the agreement.21739

       (9) Provide for the department taking action pursuant to 21740
division (B) of section 5160.21 of the Revised Code if authorized 21741
by division (A)(1), (2), (3), or (4) of that section;21742

       (10) Provide for timely audits required by federal and state 21743
law and require prompt release of audit findings and prompt action 21744
to correct problems identified in an audit;21745

       (11) Provide for administrative review procedures in 21746
accordance with section 5160.21 of the Revised Code;21747

       (12) Establish the method of amending or terminating the 21748
agreement and an expedited process for correcting terms or 21749
conditions of the agreement that the director and the board of 21750
county commissioners agree are erroneous.21751

       (D) A grant agreement does not have to be amended for a board 21752
of county commissioners to be required to comply with a new or 21753
amended condition, requirement, or restriction for an ODHCA family 21754
services duty established by federal or state law, state plan for 21755
receipt of federal financial participation, agreement between the 21756
department and a federal agency, or executive order issued by the 21757
governor.21758

       (E) The department shall make payments authorized by a grant 21759
agreement on vouchers it prepares and may include any funds 21760
appropriated or allocated to it for carrying out ODHCA family 21761
services duties for which a grant included in the agreement is 21762
awarded, including funds for personal services and maintenance.21763

       (F)(1) The director shall adopt rules in accordance with 21764
section 111.15 of the Revised Code governing grant agreements. The 21765
director shall adopt the rules as if they were internal management 21766
rules. Before adopting the rules, the director shall give the 21767
public an opportunity to review and comment on the proposed rules. 21768
The rules shall establish methodologies to be used to determine 21769
the amount of the grants included in the agreements. The rules 21770
also shall establish terms and conditions under which an agreement 21771
may be entered into after the first day of a fiscal biennial 21772
period. The rules may do any or all of the following:21773

       (a) Govern the award of grants included in grant agreements, 21774
including the establishment of, and restrictions on, the form of 21775
the grants and the distribution of the grants;21776

       (b) Specify allowable uses of the grants included in the 21777
agreements;21778

       (c) Establish reporting, cash management, audit, and other 21779
requirements the director determines are necessary to provide 21780
accountability for the use of the grants included in the 21781
agreements and determine compliance with conditions, requirements, 21782
and restrictions established by the department, a federal or state 21783
law, state plans for receipt of federal financial participation, 21784
agreements between the department and a federal agency, and 21785
executive orders issued by the governor.21786

       (2) A requirement of a grant agreement established by a rule 21787
adopted under this division is applicable to a grant agreement 21788
without having to be restated in the grant agreement. A 21789
requirement established by a grant agreement is applicable to the 21790
grant agreement without having to be restated in a rule.21791

       Sec. 5160.151.  The director of health care administration 21792
may provide for a grant agreement entered into under section 21793
5160.15 of the Revised Code to have a retroactive effective date 21794
of the first day of July of an odd-numbered year if both of the 21795
following are the case:21796

       (A) The agreement is entered into after that date and before 21797
the last day of that July.21798

       (B) The board of county commissioners requests the 21799
retroactive effective date and provides the director good cause 21800
satisfactory to the director for the reason the agreement was not 21801
entered into on or before the first day of that July.21802

       Sec. 5160.152.  The department of health care administration 21803
shall publish in a manner accessible to the public all of the 21804
following that concern ODHCA family services duties for which 21805
grants included in grant agreements entered into under section 21806
5160.15 of the Revised Code are awarded: state plans for receipt 21807
of federal financial participation, agreements between the 21808
department and a federal agency, and executive orders issued by 21809
the governor. The department may publish the materials 21810
electronically or otherwise.21811

       Sec. 5160.17. The director of health care administration may 21812
enter into a written agreement with one or more state agencies, as 21813
defined in section 117.01 of the Revised Code, and state 21814
universities and colleges to assist in the coordination, 21815
provision, or enhancement of ODHCA family services duties. The 21816
director also may enter into written agreements or contracts with, 21817
or issue grants to, private and government entities under which 21818
funds are provided for the enhancement or innovation of ODHCA 21819
family services duties on the state or local level.21820

       The director may adopt internal management rules in 21821
accordance with section 111.15 of the Revised Code to implement 21822
this section.21823

       Sec. 5160.18. The director of health care administration may 21824
enter into one or more written operational agreements with boards 21825
of county commissioners to do one or more of the following 21826
regarding ODHCA family services duties:21827

       (A) Provide for the director to amend or rescind a rule the 21828
director previously adopted;21829

       (B) Provide for the director to modify procedures or 21830
establish alternative procedures to accommodate special 21831
circumstances in a county;21832

       (C) Provide for the director and board to jointly identify 21833
operational problems of mutual concern and develop a joint plan to 21834
address the problems;21835

       (D) Establish a framework for the director and board to 21836
modify the use of existing resources in a manner that is 21837
beneficial to the department of health care administration and the 21838
county that the board serves and improves ODHCA family services 21839
duties for the recipients of the services.21840

       Sec. 5160.19. The department of health care administration 21841
may establish performance and other administrative standards for 21842
the administration and outcomes of ODHCA family services duties 21843
and determine at intervals the department decides the degree to 21844
which a county department of job and family services complies with 21845
a performance or other administrative standard. The department may 21846
use statistical sampling, performance audits, case reviews, or 21847
other methods it determines necessary and appropriate to determine 21848
compliance with performance and administrative standards.21849

       Sec. 5160.191. (A) Except as provided by division (C) of this 21850
section, if the department of health care administration 21851
determines that a county department of job and family services has 21852
failed to comply with a performance or other administrative 21853
standard established under section 5160.19 of the Revised Code or 21854
by federal law for the administration or outcome of an ODHCA 21855
family services duty, the department shall require the county 21856
department to develop, submit to the department for approval, and 21857
comply with a corrective action plan.21858

       (B) If a county department fails to develop, submit to the 21859
department, or comply with a corrective action plan under division 21860
(A) of this section, or the department disapproves the county 21861
department's corrective action plan, the department may require 21862
the county department to develop, submit to the department for 21863
approval, and comply with a corrective action plan that requires 21864
the county department to commit existing resources to the plan.21865

       (C) The department may not require a county department to 21866
take action under this section for failure to comply with a 21867
performance or other administrative standard established for an 21868
incentive awarded by the department. Instead, the department may 21869
require a county department that fails to comply with that kind of 21870
performance or other administrative standard to take action in 21871
accordance with rules adopted by the department governing the 21872
standard.21873

       (D) At the request of a county department, the department 21874
shall assist the county department with the development of a 21875
corrective action plan under this section and provide the county 21876
department technical assistance in the implementation of the plan.21877

       Sec. 5160.192. The director of health care administration may 21878
adopt rules in accordance with section 111.15 of the Revised Code 21879
to implement sections 5160.19 to 5160.192 of the Revised Code. If 21880
the director adopts the rules, the director shall adopt the rules 21881
as if they were internal management rules.21882

       Sec. 5160.20. Subject to the availability of funds, the 21883
department of health care administration may provide annual 21884
financial, administrative, or other incentive awards to county 21885
departments of job and family services. A county department may 21886
spend funds provided as a financial incentive award only for the 21887
purpose for which the funds are appropriated. The department may 21888
adopt internal management rules in accordance with section 111.15 21889
of the Revised Code to establish the amounts of awards, 21890
methodology for distributing the awards, types of awards, and 21891
standards for administration by the department.21892

       There is hereby created in the state treasury the medicaid 21893
local incentive fund. The director of health care administration 21894
may request that the director of budget and management transfer 21895
funds appropriated for ODHCA family services duties into the fund. 21896
If the director of budget and management determines that the funds 21897
identified by the director of health care administration are 21898
available and appropriate for transfer, the director of budget and 21899
management shall make the transfer. Money in the fund shall be 21900
used to provide incentive awards under this section.21901

       Sec. 5160.21.  (A) Regardless of whether an ODHCA family 21902
services duty is performed by a county department of job and 21903
family services, private or government entity pursuant to a 21904
contract entered into under section 307.982 of the Revised Code, 21905
or private or government provider of an ODHCA family service duty, 21906
the department of health care administration may take action under 21907
division (B) of this section against a board of county 21908
commissioners if the department determines any of the following 21909
are the case:21910

       (1) A requirement of a grant agreement entered into under 21911
section 5160.15 of the Revised Code that includes a grant for the 21912
ODHCA family services duty, including a requirement for grant 21913
agreements established by rules adopted under that section, is not 21914
complied with;21915

       (2) A county department fails to develop, submit to the 21916
department, or comply with a corrective action plan under division 21917
(B) of section 5160.191 of the Revised Code, or the department 21918
disapproves the county department's corrective action plan 21919
developed under division (B) of section 5160.191 of the Revised 21920
Code;21921

       (3) A requirement for the ODHCA family services duty 21922
established by the department or any of the following is not 21923
complied with: a federal or state law, state plan for receipt of 21924
federal financial participation, grant agreement between the 21925
department and a federal agency, or executive order issued by the 21926
governor;21927

       (4) The board of county commissioners is solely or partially 21928
responsible, as determined by the director of health care 21929
administration, for an adverse audit finding, adverse quality 21930
control finding, final disallowance of federal financial 21931
participation, or other sanction or penalty regarding the ODHCA 21932
family services duty.21933

       (B) The department may take one or more of the following 21934
actions against a board of county commissioners when authorized by 21935
division (A)(1), (2), (3), or (4) of this section:21936

       (1) Require the board to comply with a corrective action plan 21937
pursuant to a time schedule specified by the department. The 21938
corrective action plan shall be established or approved by the 21939
department and shall not require the board to commit resources to 21940
the plan.21941

       (2) Require the board to comply with a corrective action plan 21942
pursuant to a time schedule specified by the department. The 21943
corrective action plan shall be established or approved by the 21944
department and require the board to commit to the plan existing 21945
resources identified by the agency.21946

       (3) Require the board to do one of the following:21947

       (a) Share with the department a final disallowance of federal 21948
financial participation or other sanction or penalty;21949

       (b) Reimburse the department the final amount the department 21950
pays to the federal government or another entity that represents 21951
the amount the board is responsible for of an adverse audit 21952
finding, adverse quality control finding, final disallowance of 21953
federal financial participation, or other sanction or penalty 21954
issued by the federal government, auditor of state, or other 21955
entity;21956

       (c) Pay the federal government or another entity the final 21957
amount that represents the amount the board is responsible for of 21958
an adverse audit finding, adverse quality control finding, final 21959
disallowance of federal financial participation, or other sanction 21960
or penalty issued by the federal government, auditor of state, or 21961
other entity;21962

       (d) Pay the department the final amount that represents the 21963
amount the board is responsible for of an adverse audit finding or 21964
adverse quality control finding.21965

       (4) Impose an administrative sanction issued by the 21966
department against the board. A sanction may be increased if the 21967
department has previously taken action against the board under 21968
this division.21969

       (5) Perform, or contract with a government or private entity 21970
for the entity to perform, the ODHCA family services duty until 21971
the department is satisfied that the board ensures that the duty 21972
will be performed satisfactorily. If the department performs or 21973
contracts with an entity to perform an ODHCA family services duty 21974
under division (B)(5) of this section, the department may do 21975
either or both of the following:21976

       (a) Spend funds in the county treasury appropriated by the 21977
board for the duty;21978

       (b) Withhold funds allocated or reimbursements due to the 21979
board for the duty and spend the funds for the duty.21980

       (6) Request that the attorney general bring mandamus 21981
proceedings to compel the board to take or cease the action that 21982
causes division (A)(1), (2), (3), or (4) of this section to apply. 21983
The attorney general shall bring mandamus proceedings in the 21984
Franklin county court of appeals at the department's request.21985

       (7) If the department takes action under this division 21986
because of division (A)(3) of this section, temporarily withhold 21987
funds allocated or reimbursement due to the board until the 21988
department determines that the board is in compliance with the 21989
requirement. The department shall release the funds when the 21990
department determines that compliance has been achieved.21991

       (C) If the department proposes to take action against a board 21992
of county commissioners under division (B) of this section, the 21993
department shall notify the board, director of the county 21994
department of job and family services, and county auditor. The 21995
notice shall be in writing and specify the action the department 21996
proposes to take. The department shall send the notice by regular 21997
United States mail.21998

       Except as provided in division (D) of this section, the board 21999
may request an administrative review of a proposed action in 22000
accordance with administrative review procedures the department 22001
shall establish. The administrative review procedures shall comply 22002
with all of the following:22003

       (1) A request for an administrative review shall state 22004
specifically all of the following:22005

       (a) The proposed action specified in the notice from the 22006
department for which the review is requested;22007

       (b) The reason why the board believes the proposed action is 22008
inappropriate;22009

       (c) All facts and legal arguments that the board wants the 22010
department to consider;22011

       (d) The name of the person who will serve as the board's 22012
representative in the review.22013

       (2) If the department's notice specifies more than one 22014
proposed action and the board does not specify all of the proposed 22015
actions in its request pursuant to division (C)(1)(a) of this 22016
section, the proposed actions not specified in the request shall 22017
not be subject to administrative review and the parts of the 22018
notice regarding those proposed actions shall be final and binding 22019
on the board.22020

       (3) In the case of a proposed action under division (B)(1) of 22021
this section, the board shall have fifteen calendar days after the 22022
department mails the notice to the board to send a written request 22023
to the department for an administrative review. If it receives 22024
such a request within the required time, the department shall 22025
postpone taking action under division (B)(1) of this section for 22026
fifteen calendar days following the day it receives the request or 22027
for the extended period of time provided for in division (C)(5) 22028
of this section to allow a representative of the department and a 22029
representative of the board an informal opportunity to resolve any 22030
dispute during that fifteen-day or extended period.22031

       (4) In the case of a proposed action under division (B)(2), 22032
(3), (4), (5), or (7) of this section, the board shall have thirty 22033
calendar days after the department mails the notice to the board 22034
to send a written request to the department for an administrative 22035
review. If it receives such a request within the required time, 22036
the department shall postpone taking action under division (B)(2), 22037
(3), (4), (5), or (7) of this section for thirty calendar days 22038
following the day it receives the request or for the extended 22039
period of time provided for in division (C)(5) of this section to 22040
allow a representative of the department and a representative of 22041
the board an informal opportunity to resolve any dispute during 22042
that thirty-day or extended period.22043

       (5) If the informal opportunity provided in division (C)(3) 22044
or (4) of this section does not result in a written resolution to 22045
the dispute within the fifteen- or thirty-day period, the director 22046
of health care administration and representative of the board may 22047
enter into a written agreement extending the time period for 22048
attempting an informal resolution of the dispute under division 22049
(C)(3) or (4) of this section.22050

       (6) In the case of a proposed action under division (B)(3) of 22051
this section, the board may not include in its request disputes 22052
over a finding, final disallowance of federal financial 22053
participation, or other sanction or penalty issued by the federal 22054
government, auditor of state, or entity other than the department.22055

       (7) If the board fails to request an administrative review 22056
within the required time, the board loses the right to request an 22057
administrative review of the proposed actions specified in the 22058
notice and the notice becomes final and binding on the board.22059

       (8) If the informal opportunity provided in division (C)(3) 22060
or (4) of this section does not result in a written resolution to 22061
the dispute within the time provided by division (C)(3), (4), or 22062
(5) of this section, the director shall appoint an administrative 22063
review panel to conduct the administrative review. The review 22064
panel shall consist of department employees and one county 22065
director of job and family services or other representative of a 22066
county department of job and family services from a different 22067
county than the county served by the board. No individual involved 22068
in the department's proposal to take action against the board may 22069
serve on the review panel. The review panel shall review the 22070
board's request. The review panel may require that the department 22071
or board submit additional information and schedule and conduct an 22072
informal hearing to obtain testimony or additional evidence. A 22073
review of a proposal to take action under division (B)(3) of this 22074
section shall be limited solely to the issue of the amount the 22075
board shall share with the department, reimburse the department, 22076
or pay to the federal government, department, or other entity 22077
under division (B)(3) of this section. The review panel is not 22078
required to make a stenographic record of its hearing or other 22079
proceedings.22080

       (9) After finishing an administrative review, an 22081
administrative review panel appointed under division (C)(8) of 22082
this section shall submit a written report to the director setting 22083
forth its findings of fact, conclusions of law, and 22084
recommendations for action. The director may approve, modify, or 22085
disapprove the recommendations. If the director modifies or 22086
disapproves the recommendations, the director shall state the 22087
reasons for the modification or disapproval and the actions to be 22088
taken against the board.22089

       (10) The director's approval, modification, or disapproval 22090
under division (C)(9) of this section shall be final and binding 22091
on the board and shall not be subject to further departmental 22092
review.22093

       (D) A board of county commissioners is not entitled to an 22094
administrative review under division (C) of this section for any 22095
of the following:22096

       (1) An action taken under division (B)(6) of this section;22097

       (2) An action taken under section 5160.211 of the Revised 22098
Code;22099

       (3) An action taken under division (B)(3) of this section if 22100
the federal government, auditor of state, or entity other than the 22101
department has identified the board as being solely or partially 22102
responsible for an adverse audit finding, adverse quality control 22103
finding, final disallowance of federal financial participation, or 22104
other sanction or penalty;22105

       (4) An adjustment to an allocation, cash draw, advance, or 22106
reimbursement to the board that the department determines 22107
necessary for budgetary reasons;22108

       (5) Withholding of a cash draw or reimbursement due to 22109
noncompliance with a reporting requirement established in rules 22110
adopted under section 5160.22 of the Revised Code.22111

       (E) This section does not apply to other actions the 22112
department takes against a board of county commissioners pursuant 22113
to authority granted by another state law unless the other state 22114
law requires the department to take the action in accordance with 22115
this section.22116

       (F) The director of health care administration may adopt 22117
rules in accordance with Chapter 119. of the Revised Code as 22118
necessary to implement this section.22119

       Sec. 5160.211. The department of health care administration 22120
may certify a claim to the attorney general under section 131.02 22121
of the Revised Code for the attorney general to take action under 22122
that section against a board of county commissioners to recover 22123
any funds that the department determines the board owes the 22124
department for actions taken under division (B)(2), (3), (4), or 22125
(5) of section 5160.21 of the Revised Code.22126

       Sec. 5160.22. The director of health care administration may 22127
adopt rules in accordance with section 111.15 of the Revised Code 22128
establishing reporting requirements for ODHCA family services 22129
duties. If the director adopts the rules, the director shall adopt 22130
the rules as if they were internal management rules and, before 22131
adopting the rules, give the public an opportunity to review and 22132
comment on the proposed rules.22133

       Sec. 5160.23. If the department of health care administration 22134
determines that a grant awarded to a board of county commissioners 22135
in a grant agreement entered into under section 5160.15 of the 22136
Revised Code, an allocation, advance, or reimbursement the 22137
department makes to a county department of job and family 22138
services, or a cash draw a county department of job and family 22139
services makes exceeds the allowable amount for the grant, 22140
allocation, advance, reimbursement, or cash draw, the department 22141
may adjust, offset, withhold, or reduce an allocation, cash draw, 22142
advance, reimbursement, or other financial assistance to the board 22143
or county department as necessary to recover the amount of the 22144
excess grant, allocation, advance, reimbursement, or cash draw. 22145
The department is not required to make the adjustment, offset, 22146
withholding, or reduction in accordance with section 5160.21 of 22147
the Revised Code.22148

       The director of health care administration may adopt rules 22149
under section 111.15 of the Revised Code as necessary to implement 22150
this section. The director shall adopt the rules as if they were 22151
internal management rules.22152

       Sec. 5160.24. The department of health care administration, 22153
in consultation with county representatives, shall develop annual 22154
training goals and model training curriculum regarding ODHCA 22155
family services duties for employees of county departments of job 22156
and family services and identify a variety of state funded 22157
training opportunities to meet the proposed goals.22158

       Sec. 5160.26. (A) As used in sections 5160.26 to 5160.262 of 22159
the Revised Code:22160

       "Disability medical assistance expenditures" means 22161
expenditures for the disability medical assistance program and 22162
county administration of the disability medical assistance 22163
program.22164

       "Medicaid expenditures" means expenditures for county 22165
administration of the medicaid program. "Medicaid expenditures" 22166
does not include expenditures for transportation services provided 22167
under the medicaid program.22168

       "Public assistance expenditures" has the same meaning as in 22169
section 5101.16 of the Revised Code.22170

       "Public medical assistance expenditures" means disability 22171
medical assistance expenditures and medicaid expenditures.22172

       (B) Except as provided in division (C) of this section, a 22173
county's share of public medical assistance expenditures is the 22174
sum of the following for each state fiscal year:22175

       (1) The amount that is twenty-five per cent of the county's 22176
total disability medical assistance expenditures during the state 22177
fiscal year ending in the previous calendar year that the 22178
department of health care administration determines are allowable;22179

       (2) The amount that is ten per cent, or other percentage 22180
determined under division (D) of this section, of the county's 22181
total medicaid expenditures during the state fiscal year ending in 22182
the previous calendar year that the department of health care 22183
administration determines are allowable, less the amount of 22184
federal reimbursement credited to the county under division (E) of 22185
this section for the state fiscal year ending in the previous 22186
calendar year.22187

       (C)(1) If a county's share of public medical assistance 22188
expenditures determined under division (B) of this section and the 22189
county's share of public assistance expenditures determined under 22190
division (B) of section 5101.16 of the Revised Code for a state 22191
fiscal year exceeds one hundred ten per cent of the county's share 22192
for those expenditures for the immediately preceding state fiscal 22193
year, the department of health care administration shall reduce 22194
the county's share for public medical assistance expenditures so 22195
that the total of the county's share for public medical assistance 22196
expenditures and public assistance expenditures equals one hundred 22197
ten per cent of the county's share of those expenditures for the 22198
immediately preceding state fiscal year. The department of health 22199
care administration shall cooperate with the department of job and 22200
family services for the purpose of making reductions under 22201
division (C)(1) of this section.22202

       (2) A county's share of public medical assistance 22203
expenditures determined under division (B) of this section may be 22204
increased pursuant to a sanction under section 5160.21 of the 22205
Revised Code.22206

       (D)(1) If the per capita tax duplicate of a county is less 22207
than the per capita tax duplicate of the state as a whole and 22208
division (D)(2) of this section does not apply to the county, the 22209
percentage to be used for the purpose of division (B)(2) of this 22210
section is the product of ten multiplied by a fraction of which 22211
the numerator is the per capita tax duplicate of the county and 22212
the denominator is the per capita tax duplicate of the state as a 22213
whole. The department of health care administration shall compute 22214
the per capita tax duplicate for the state and for each county by 22215
dividing the tax duplicate for the most recent available year by 22216
the current estimate of population prepared by the department of 22217
development.22218

       (2) If the percentage of families in a county with an annual 22219
income of less than three thousand dollars is greater than the 22220
percentage of such families in the state and division (D)(1) of 22221
this section does not apply to the county, the percentage to be 22222
used for the purpose of division (B)(2) of this section is the 22223
product of ten multiplied by a fraction of which the numerator is 22224
the percentage of families in the state with an annual income of 22225
less than three thousand dollars a year and the denominator is the 22226
percentage of such families in the county. The department of 22227
health care administration shall compute the percentage of 22228
families with an annual income of less than three thousand dollars 22229
for the state and for each county by multiplying the most recent 22230
estimate of such families published by the department of 22231
development, by a fraction, the numerator of which is the estimate 22232
of average annual personal income published by the bureau of 22233
economic analysis of the United States department of commerce for 22234
the year on which the census estimate is based and the denominator 22235
of which is the most recent such estimate published by the bureau.22236

       (3) If the per capita tax duplicate of a county is less than 22237
the per capita tax duplicate of the state as a whole and the 22238
percentage of families in the county with an annual income of less 22239
than three thousand dollars is greater than the percentage of such 22240
families in the state, the percentage to be used for the purpose 22241
of division (B)(2) of this section shall be determined as follows:22242

       (a) Multiply ten by the fraction determined under division 22243
(D)(1) of this section;22244

       (b) Multiply the product determined under division (D)(3)(a) 22245
of this section by the fraction determined under division (D)(2) 22246
of this section.22247

       (4) The department of health care administration shall 22248
determine, for each county, the percentage to be used for the 22249
purpose of division (B)(2) of this section not later than the 22250
first day of July of the year preceding the state fiscal year for 22251
which the percentage is used.22252

       (E) The department of health care administration shall credit 22253
to a county the amount of federal reimbursement the department 22254
receives from the United States department of health and human 22255
services for the county's medicaid expenditures that the 22256
department determines are allowable administrative expenditures.22257

       (F) The director of health care administration shall adopt 22258
rules in accordance with section 111.15 of the Revised Code to 22259
establish all of the following:22260

       (1) The method the department of health care administration 22261
is to use to change a county's share of public medical assistance 22262
expenditures determined under division (B) of this section as 22263
provided in division (C) of this section;22264

       (2) The allocation methodology and formula the department 22265
will use to determine the amount of funds to credit to a county 22266
under this section;22267

       (3) The method the department will use to change the payment 22268
of the county share of public medical assistance expenditures from 22269
a calendar-year basis to a state fiscal year basis;22270

       (4) Other procedures and requirements necessary to implement 22271
this section.22272

       Sec. 5160.261. Prior to the sixteenth day of May annually, 22273
the department of health care administration shall certify to the 22274
board of county commissioners of each county the amount estimated 22275
by the department to be needed in the following state fiscal year 22276
to meet the county share, as determined under section 5160.26 of 22277
the Revised Code, of public medical assistance expenditures. Each 22278
January, the board shall appropriate the amount certified by the 22279
department and an additional five per cent of that amount. Each 22280
June, the board may reappropriate, for any purpose the board 22281
determines to be appropriate, the amount appropriated in January 22282
that exceeds the total of the amount certified by the department 22283
for the last six months of the current state fiscal year and the 22284
first six months of the following state fiscal year.22285

       Before the fifteenth day of each payment period the director 22286
of health care administration establishes by rule, the department 22287
of health care administration shall pay a county the estimated 22288
state and federal share of the county's public medical assistance 22289
expenditures for that payment period increased or decreased by the 22290
amount the department underpaid or overpaid the county for the 22291
most recent payment period that the department knows an 22292
underpayment or overpayment was made.22293

       If the department establishes a maximum amount that it will 22294
reimburse a county for public medical assistance expenditures and 22295
a county spends more for public medical assistance expenditures 22296
than is reimbursable, the department shall not pay the county a 22297
state or, except as provided in section 5160.262 of the Revised 22298
Code, a federal share for the amount of the expenditure that 22299
exceeds the maximum allowable reimbursement amount. County 22300
expenditures that exceed the maximum allowable reimbursement 22301
amount shall not be credited to a county's share of public medical 22302
assistance expenditures under section 5160.26 of the Revised Code. 22303
The department also shall not pay a county a state or, except as 22304
provided in section 5160.262 of the Revised Code, a federal share 22305
for an administrative expenditure that is not allowed by the 22306
department.22307

       A county shall deposit all funds appropriated by a board of 22308
county commissioners and received from the department under this 22309
section in a special fund in the county treasury known as the 22310
public assistance fund. A county shall make payments for public 22311
medical assistance expenditures from the public assistance fund.22312

       The attorney general shall bring mandamus proceedings in the 22313
Franklin county court of appeals against any board of county 22314
commissioners that fails to make appropriations or deposits into 22315
the public assistance fund required by this section.22316

       The director shall adopt internal management rules in 22317
accordance with section 111.15 of the Revised Code to do all of 22318
the following:22319

       (A) Establish the method by which the department is to make 22320
payments to counties under this section;22321

       (B) Establish procedures for payment by counties of the 22322
county share of public medical assistance expenditures;22323

       (C) Establish payment periods for paying a county its 22324
estimated state and federal share of public medical assistance 22325
expenditures;22326

       (D) Allow county departments of job and family services to 22327
use the public assistance fund for other purposes and programs 22328
similar to the disability medical assistance program and medicaid 22329
program.22330

       The director may adopt internal management rules in 22331
accordance with section 111.15 of the Revised Code to establish a 22332
maximum amount that it will reimburse a county for public medical 22333
assistance expenditures.22334

       Sec. 5160.262. Subject to available federal funds and 22335
appropriations made by the general assembly, the department of 22336
health care administration may, at its sole discretion, use 22337
available federal funds to reimburse a county for medicaid 22338
expenditures even though the county's medicaid expenditures meet 22339
or exceed the maximum allowable reimbursement amount established 22340
by rules adopted under section 5160.261 of the Revised Code. The 22341
director may adopt internal management rules in accordance with 22342
section 111.15 of the Revised Code to implement this section.22343

       Sec. 5160.28. The department of health care administration 22344
may make any investigations that are necessary in the performance 22345
of its duties, and to that end the department shall have the same 22346
power as a judge of a county court to administer oaths and to 22347
enforce the attendance and testimony of witnesses and the 22348
production of books or papers.22349

       The department shall keep a record of its investigations 22350
stating the time, place, charges or subject, witnesses summoned 22351
and examined, and their conclusions.22352

       Witnesses shall be paid the fees and mileage provided for 22353
under section 119.094 of the Revised Code.22354

       Sec. 5160.29. Any judge of any division of the court of 22355
common pleas, upon application of the department of health care 22356
administration, may compel the attendance of witnesses, the 22357
production of books or papers, and the giving of testimony before 22358
the department, by a judgment for contempt or otherwise, in the 22359
same manner as in cases before those courts.22360

       Sec. 5160.30. The department of health care administration 22361
may appoint and commission any competent officer, employee, 22362
agency, or person to serve as a special agent, investigator, or 22363
representative to perform a designated duty for and in behalf of 22364
the department. Specific credentials shall be given by the 22365
department to each person so designated, and each credential shall 22366
state:22367

       (A) The person's name;22368

       (B) Agency with which such person is connected;22369

       (C) Purpose of appointment;22370

       (D) Date of expiration of appointment, if appropriate;22371

       (E) Such information as the department considers proper.22372

       Sec. 5160.32. (A) Subject to division (B) of this section, 22373
the director of health care administration may accept 22374
applications, determine eligibility, redetermine eligibility, and 22375
perform related administrative activities for one or more of the 22376
following:22377

       (1) The medicaid program;22378

       (2) The children's health insurance program;22379

       (3) The children's buy-in program;22380

       (4) Other programs regarding which the director determines 22381
administrative cost savings and efficiency may be achieved through 22382
the department accepting applications, determining eligibility, 22383
redetermining eligibility, or performing related administrative 22384
activities.22385

       (B) If federal law requires a face-to-face interview to 22386
complete an eligibility determination for a program, the 22387
face-to-face interview shall not be conducted by the department of 22388
health care administration.22389

       (C) Subject to division (B) of this section, if the director 22390
elects to accept applications, determine eligibility, redetermine 22391
eligibility, and perform related administrative activities for a 22392
program under this section, both of the following apply:22393

       (1) An individual seeking services under the program may 22394
apply for the program to the director or to the entity that state 22395
law governing the program authorizes to accept applications for 22396
the program.22397

       (2) The director is subject to federal statutes and 22398
regulations and state statutes and rules that require, permit, or 22399
prohibit an action regarding accepting applications, determining 22400
or redetermining eligibility, and performing related 22401
administrative activities for the program.22402

       (D) The director may adopt rules as necessary to implement 22403
this section.22404

       Sec. 5160.34. (A) As used in this section:22405

       (1) "Agency" means the following entities that administer an 22406
ODHCA program:22407

       (a) The department of health care administration;22408

       (b) A county department of job and family services;22409

       (c) A private or government entity administering, in whole or 22410
in part, an ODHCA program for or on behalf of the department of 22411
health care administration or a county department of job and 22412
family services.22413

       (2) "Appellant" means an applicant, participant, former 22414
participant, recipient, or former recipient of an ODHCA program 22415
who is entitled by federal or state law to a hearing regarding a 22416
decision or order of the agency that administers the program.22417

       (3) "ODHCA program" means the disability medical assistance 22418
program, the medicaid program, and residential state supplement 22419
program.22420

       (B) Except as provided by division (F) of this section, an 22421
appellant who appeals under federal or state law a decision or 22422
order of an agency administering an ODHCA program shall, at the 22423
appellant's request, be granted a state hearing by the department 22424
of health care administration. This state hearing shall be 22425
conducted in accordance with rules adopted under this section. The 22426
state hearing shall be recorded, but neither the recording nor a 22427
transcript of the recording shall be part of the official record 22428
of the proceeding. A state hearing decision is binding upon the 22429
agency and department, unless it is reversed or modified on appeal 22430
to the director of health care administration or a court of common 22431
pleas.22432

       (C) An appellant who disagrees with a state hearing decision 22433
may make an administrative appeal to the director of health care 22434
administration in accordance with rules adopted under this 22435
section. This administrative appeal does not require a hearing, 22436
but the director or the director's designee shall review the state 22437
hearing decision and previous administrative action and may 22438
affirm, modify, remand, or reverse the state hearing decision. Any 22439
person designated to make an administrative appeal decision on 22440
behalf of the director shall have been admitted to the practice of 22441
law in this state. An administrative appeal decision is the final 22442
decision of the department and is binding upon the department and 22443
agency, unless it is reversed or modified on appeal to the court 22444
of common pleas.22445

       (D) An agency shall comply with a decision issued pursuant to 22446
division (B) or (C) of this section within the time limits 22447
established by rules adopted under this section. If a county 22448
department of job and family services fails to comply within these 22449
time limits, the department may take action pursuant to section 22450
5160.21 of the Revised Code. If another agency fails to comply 22451
within the time limits, the department may force compliance by 22452
withholding funds due the agency or imposing another sanction 22453
established by rules adopted under this section.22454

       (E) An appellant who disagrees with an administrative appeal 22455
decision of the director of health care administration or the 22456
director's designee issued under division (C) of this section may 22457
appeal from the decision to the court of common pleas pursuant to 22458
section 119.12 of the Revised Code. The appeal shall be governed 22459
by section 119.12 of the Revised Code except that:22460

       (1) The person may appeal to the court of common pleas of the 22461
county in which the person resides, or to the court of common 22462
pleas of Franklin county if the person does not reside in this 22463
state.22464

       (2) The person may apply to the court for designation as an 22465
indigent and, if the court grants this application, the appellant 22466
shall not be required to furnish the costs of the appeal.22467

       (3) The appellant shall mail the notice of appeal to the 22468
department of health care administration and file notice of appeal 22469
with the court within thirty days after the department mails the 22470
administrative appeal decision to the appellant. For good cause 22471
shown, the court may extend the time for mailing and filing notice 22472
of appeal, but such time shall not exceed six months from the date 22473
the department mails the administrative appeal decision. Filing 22474
notice of appeal with the court shall be the only act necessary to 22475
vest jurisdiction in the court.22476

       (4) The department shall be required to file a transcript of 22477
the testimony of the state hearing with the court only if the 22478
court orders the department to file the transcript. The court 22479
shall make such an order only if it finds that the department and 22480
the appellant are unable to stipulate to the facts of the case and 22481
that the transcript is essential to a determination of the appeal. 22482
The department shall file the transcript not later than thirty 22483
days after the day such an order is issued.22484

       (F) If an appellant receiving medicaid through a health 22485
insuring corporation that holds a certificate of authority under 22486
Chapter 1751. of the Revised Code is appealing a denial of 22487
medicaid services based on lack of medical necessity or other 22488
clinical issues regarding coverage by the health insuring 22489
corporation, the person hearing the appeal may order an 22490
independent medical review if that person determines that a review 22491
is necessary. The review shall be performed by a health care 22492
professional with appropriate clinical expertise in treating the 22493
recipient's condition or disease. The department shall pay the 22494
costs associated with the review.22495

       A review ordered under this division shall be part of the 22496
record of the hearing and shall be given appropriate evidentiary 22497
consideration by the person hearing the appeal.22498

       (G) The director of health care administration shall adopt 22499
rules in accordance with Chapter 119. of the Revised Code to 22500
implement this section, including rules governing the following:22501

       (1) State hearings under division (B) of this section. The 22502
rules shall include provisions regarding notice of eligibility 22503
termination and the opportunity of an appellant appealing a 22504
decision or order of a county department of job and family 22505
services to request a county conference with the county department 22506
before the state hearing is held.22507

       (2) Administrative appeals under division (C) of this 22508
section;22509

       (3) Time limits for complying with a decision issued under 22510
division (B) or (C) of this section;22511

       (4) Sanctions that may be applied against an agency under 22512
division (D) of this section.22513

       (H) The requirements of Chapter 119. of the Revised Code 22514
apply to a state hearing or administrative appeal under this 22515
section only to the extent, if any, specifically provided by rules 22516
adopted under this section.22517

       Sec. 5160.341. The department of health care administration 22518
may employ or contract with hearing officers to draft and 22519
recommend state hearing decisions under division (B) of section 22520
5160.34 of the Revised Code. The department may employ or contract 22521
with hearing authorities to issue state hearing decisions under 22522
division (B) of section 5160.34 of the Revised Code. Except in the 22523
case of an individual who was employed by or under contract with 22524
the department of job and family services to perform the duties of 22525
a hearing authority under division (B) of section 5101.35 of the 22526
Revised Code before July 1, 2000, an individual performing the 22527
duties of a hearing authority shall have been admitted to the 22528
practice of law in this state.22529

       Sec. 5101.571.        Sec. 5160.36.  As used in sections 5101.5715160.3622530
to 5101.5915160.41 of the Revised Code:22531

       (A) "Information" means all of the following:22532

       (1) An individual's name, address, date of birth, and social 22533
security number;22534

       (2) The group or plan number, or other identifier, assigned 22535
by a third party to a policy held by an individual or a plan in 22536
which the individual participates and the nature of the coverage;22537

       (3) Any other data the director of job and family services22538
health care administration specifies in rules adopted under 22539
section 5101.5915160.41 of the Revised Code.22540

       (B) "Medical assistance" means medical items or services 22541
provided under any of the following:22542

        (1) Medicaid, as defined in section 5111.01 of the Revised 22543
Code;22544

       (2) The children's health insurance program part I, part II, 22545
and part III established under sections 5101.50 to 5101.529 of the 22546
Revised Code;22547

       (3) The disability medical assistance program established 22548
under Chapter 5115. of the Revised Code;22549

       (4) The children's buy-in program established under sections 22550
5101.5211 to 5101.5216 of the Revised Code.22551

       (C) "Medical support" means support specified as support for 22552
the purpose of medical care by order of a court or administrative 22553
agency.22554

        (D) "Public assistance" means medical assistance or 22555
assistance under the Ohio works first program established under 22556
Chapter 5107. of the Revised Code.22557

       (E)(1) Subject to division (E)(2) of this section, and except 22558
as provided in division (E)(3) of this section, "third party" 22559
means all of the following:22560

       (a) A person authorized to engage in the business of sickness 22561
and accident insurance under Title XXXIX of the Revised Code;22562

       (b) A person or governmental entity providing coverage for 22563
medical services or items to individuals on a self-insurance 22564
basis;22565

       (c) A health insuring corporation as defined in section 22566
1751.01 of the Revised Code;22567

       (d) A group health plan as defined in 29 U.S.C. 1167;22568

       (e) A service benefit plan as referenced in 42 U.S.C. 22569
1396a(a)(25);22570

       (f) A managed care organization;22571

       (g) A pharmacy benefit manager;22572

       (h) A third party administrator;22573

       (i) Any other person or governmental entity that is, by law, 22574
contract, or agreement, responsible for the payment or processing 22575
of a claim for a medical item or service for a public assistance 22576
recipient or participant.22577

       (2) Except when otherwise provided by 42 U.S.C. 1395y(b), a 22578
person or governmental entity listed in division (E)(1) of this 22579
section is a third party even if the person or governmental entity 22580
limits or excludes payments for a medical item or service in the 22581
case of a public assistance recipient.22582

       (3) "Third party" does not include the program for medically 22583
handicapped children established under section 3701.023 of the 22584
Revised Code.22585

       Sec. 5101.59.        Sec. 5160.37.  (A) The application for, or acceptance 22586
of, public assistance constitutes an automatic assignment of22587
certain rights to the department of job and family services22588
health care administration. This assignment includes the rights 22589
of the applicant, recipient, or participant and also the rights of 22590
any other member of the assistance group for whom the applicant,22591
recipient, or participant can legally make an assignment.22592

       (B) Pursuant to this section, the applicant, recipient, or 22593
participant assigns to the department any rights to medical 22594
support available to the applicant, recipient, or participant or 22595
for other members of the assistance group under an order of a 22596
court or administrative agency, and any rights to payments by a 22597
liable third party for the cost of medical assistance paid on 22598
behalf of a public assistance recipient or participant. The 22599
recipient or participant shall cooperate with the department in 22600
obtaining such payments.22601

       Medicare benefits shall not be assigned pursuant to this22602
section. Benefits assigned to the department by operation of this 22603
section are directly reimbursable to the department by liable 22604
third parties.22605

       (C) Refusal by the applicant, recipient, or participant to 22606
cooperate in obtaining medical assistance paid for self or any22607
other member of the assistance group renders the applicant,22608
recipient, or participant ineligible for public assistance, unless 22609
cooperation is waived by the department. Eligibility shall22610
continue for any individual who cannot legally assign the22611
individual's own rights and who would have been eligible for 22612
public assistance but for the refusal to assign the individual's 22613
rights or to cooperate as required by this section by another 22614
person legally able to assign the individual's rights.22615

       (D) If the applicant, recipient, or participant or any member 22616
of the assistance group becomes ineligible for public assistance, 22617
the department shall restore to the applicant, recipient, 22618
participant, or member of the assistance group any future rights 22619
to benefits assigned under this section.22620

       (E) The rights of assignment given to the department under 22621
this section do not include rights to support assigned under 22622
section 5107.20 or 5115.07 of the Revised Code.22623

       Sec. 5101.58.        Sec. 5160.38. (A) The acceptance of public assistance 22624
gives an automatic right of recovery to the department of job 22625
and family serviceshealth care administration and a county 22626
department of job and family services against the liability of a 22627
third party for the cost of medical assistance paid on behalf of 22628
the public assistance recipient or participant. When an action 22629
or claim is brought against a third party by a public assistance 22630
recipient or participant, any payment, settlement or compromise 22631
of the action or claim, or any court award or judgment, is 22632
subject to the recovery right of the department of job and family 22633
serviceshealth care administration or county department of job 22634
and family services. Except in the case of a recipient or 22635
participant who receives medical assistance through a managed 22636
care organization, the department's or county department's claim 22637
shall not exceed the amount of medical assistance paid by a 22638
department on behalf of the recipient or participant. A payment, 22639
settlement, compromise, judgment, or award that excludes the 22640
cost of medical assistance paid for by a department shall not 22641
preclude a department from enforcing its rights under this 22642
section.22643

       (B) In the case of a recipient or participant who receives 22644
medical assistance through a managed care organization, the 22645
amount of the department's or county department's claim shall be 22646
the amount the managed care organization pays for medical 22647
assistance rendered to the recipient or participant, even if that 22648
amount is more than the amount a department pays to the managed 22649
care organization for the recipient's or participant's medical 22650
assistance.22651

        (C) A recipient or participant, and the recipient's or 22652
participant's attorney, if any, shall cooperate with the 22653
departments. In furtherance of this requirement, the recipient or 22654
participant, or the recipient's or participant's attorney, if 22655
any, shall, not later than thirty days after initiating informal 22656
recovery activity or filing a legal recovery action against a 22657
third party, provide written notice of the activity or action to 22658
the appropriate department or departments as follows:22659

       (1) To only the department of job and family serviceshealth 22660
care administration when medical assistance under medicaid or the 22661
children's buy-in program has been paid;22662

       (2) To the department of job and family serviceshealth care 22663
administration and the appropriate county department of job and 22664
family services when medical assistance under the disability 22665
medical assistance program has been paid.22666

       (D) The written notice that must be given under division (C) 22667
of this section shall disclose the identity and address of any 22668
third party against whom the recipient or participant has or may 22669
have a right of recovery.22670

       (E) No settlement, compromise, judgment, or award or any 22671
recovery in any action or claim by a recipient or participant 22672
where the departments have a right of recovery shall be made final 22673
without first giving the appropriate departments written notice as 22674
described in division (C) of this section and a reasonable 22675
opportunity to perfect their rights of recovery. If the22676
departments are not given the appropriate written notice, the 22677
recipient or participant and, if there is one, the recipient's or 22678
participant's attorney, are liable to reimburse the departments 22679
for the recovery received to the extent of medical payments made 22680
by the departments.22681

       (F) The departments shall be permitted to enforce their 22682
recovery rights against the third party even though they accepted 22683
prior payments in discharge of their rights under this section if, 22684
at the time the departments received such payments, they were not 22685
aware that additional medical expenses had been incurred but had 22686
not yet been paid by the departments. The third party becomes 22687
liable to the department of job and family serviceshealth care 22688
administration or county department of job and family services as 22689
soon as the third party is notified in writing of the valid 22690
claims for recovery under this section.22691

        (G)(1) Subject to division (G)(2) of this section, the right 22692
of recovery of a department does not apply to that portion of any 22693
judgment, award, settlement, or compromise of a claim, to the 22694
extent of attorneys' fees, costs, or other expenses incurred by a 22695
recipient or participant in securing the judgment, award, 22696
settlement, or compromise, or to the extent of medical, surgical, 22697
and hospital expenses paid by such recipient or participant from 22698
the recipient's or participant's own resources.22699

        (2) Reasonable attorneys' fees, not to exceed one-third of 22700
the total judgment, award, settlement, or compromise, plus costs 22701
and other expenses incurred by the recipient or participant in 22702
securing the judgment, award, settlement, or compromise, shall 22703
first be deducted from the total judgment, award, settlement, or 22704
compromise. After fees, costs, and other expenses are deducted 22705
from the total judgment, award, settlement, or compromise, the 22706
department of job and family serviceshealth care administration22707
or appropriate county department of job and family services shall 22708
receive no less than one-half of the remaining amount, or the 22709
actual amount of medical assistance paid, whichever is less.22710

       (H) A right of recovery created by this section may be 22711
enforced separately or jointly by the department of job and family 22712
serviceshealth care administration or the appropriate county 22713
department of job and family services. To enforce their recovery 22714
rights, the departments may do any of the following:22715

       (1) Intervene or join in any action or proceeding brought by 22716
the recipient or participant or on the recipient's or 22717
participant's behalf against any third party who may be liable for 22718
the cost of medical assistance paid;22719

       (2) Institute and pursue legal proceedings against any third 22720
party who may be liable for the cost of medical assistance paid;22721

       (3) Initiate legal proceedings in conjunction with any22722
injured, diseased, or disabled recipient or participant or the 22723
recipient's or participant's attorney or representative.22724

       (I) A recipient or participant shall not assess attorney 22725
fees, costs, or other expenses against the department of job and 22726
family serviceshealth care administration or a county department 22727
of job and family services when the department or county 22728
department enforces its right of recovery created by this 22729
section.22730

       (J) The right of recovery given to the department under this22731
section does not include rights to support from any other person22732
assigned to the state under sections 5107.20 and 5115.07 of the 22733
Revised Code, but includes payments made by a third party under 22734
contract with a person having a duty to support.22735

       Sec. 5111.121.        Sec. 5160.39.  (A) As used in this section, "third 22736
party" has the same meaning as in section 5101.571 of the Revised 22737
Code.22738

       (B) In addition to the authority granted under section22739
5101.595160.37 of the Revised Code, the department of job and 22740
family serviceshealth care administration may, to the extent 22741
necessary to reimburse its costs, garnish the wages, salary, or 22742
other employment income of, and withhold amounts from state tax 22743
refunds to, any person to whom both of the following apply:22744

       (1) The person is required by a court or administrative order 22745
to provide coverage of the cost of health care services to a child 22746
eligible for medical assistance under this chapterthe medicaid 22747
program.22748

       (2) The person has received payment from a third party for22749
the costs of such services but has not used the payment to22750
reimburse either the other parent or guardian of the child or the22751
provider of the services.22752

       (C)(B) Claims for current and past due child support shall22753
take priority over claims under division (B)(A) of this section.22754

       Sec. 5101.572.        Sec. 5160.40.  (A) A third party shall cooperate 22755
with the department of job and family serviceshealth care 22756
administration in identifying individuals for the purpose of 22757
establishing third party liability pursuant to Title XIX of the 22758
Social Security Act, as amendedfor the medicaid program.22759

       (B) In furtherance of the requirement in division (A) of this 22760
section and to allow the department to determine any period that 22761
the individual or the individual's spouse or dependent may have 22762
been covered by the third party and the nature of the coverage, a 22763
third party shall provide, as the department so chooses, 22764
information or access to information, or both, in the third 22765
party's electronic data system on the department's request and in 22766
accordance with division (C) of this section.22767

       (C)(1) If the department chooses to receive information 22768
directly, the third party shall provide the information under all 22769
of the following circumstances:22770

       (a) In a medium, format, and manner prescribed by the 22771
director of job and family serviceshealth care administration in 22772
rules adopted under section 5101.5915160.41 of the Revised Code;22773

       (b) Free of charge;22774

       (c) Not later than the end of the thirtieth day after the 22775
department makes its request, unless a different time is agreed to 22776
by the director in writing.22777

       (2) If the department chooses to receive access to 22778
information, the third party shall provide access by a method 22779
prescribed by the director of job and family serviceshealth care 22780
administration in rules adopted under section 5101.5915160.41 of 22781
the Revised Code. In facilitating access, the department may 22782
enter into a trading partner agreement with the third party to 22783
permit the exchange of information via "ASC X 12N 270/271 Health 22784
Care Eligibility Benefit Inquiry and Response" transactions.22785

       (D) All of the following apply with respect to information 22786
provided by a third party to the department under this section:22787

       (1) The information is confidential and not a public record 22788
under section 149.43 of the Revised Code.22789

       (2) The release of information to the department is not to be 22790
considered a violation of any right of confidentiality or contract 22791
that the third party may have with covered persons including, but 22792
not limited to, contractees, beneficiaries, heirs, assignees, and 22793
subscribers.22794

       (3) The third party is immune from any liability that it may 22795
otherwise incur through its release of information to the 22796
department.22797

       The department of job and family serviceshealth care 22798
administration shall limit its use of information gained from 22799
third parties to purposes directly connected with the 22800
administration of the medicaid program and the child support 22801
program authorized by Title IV-D of the "Social Security Act."22802

       (E) No third party shall disclose to other parties or make 22803
use of any information regarding recipients of aid under Chapter 22804
5107. or 5111. of the Revised Code or the medicaid program that it 22805
obtains from the department, except in the manner provided for22806
by the director of job and family serviceshealth care 22807
administration in administrative rules.22808

       (F) The department of health care administration may enter 22809
into an interagency agreement with the department of job and 22810
family services as necessary to implement this section as regards 22811
recipients of assistance under Chapter 5107. of the Revised Code 22812
and the child support program authorized by Title IV-D of the 22813
"Social Security Act."22814

       Sec. 5101.573.        Sec. 5160.401. (A) Subject to divisions (B) and (C) 22815
of this section, a third party shall do all of the following:22816

       (1) Accept the department of job and family services'health 22817
care administration's right of recovery under section 5101.5822818
5160.38 of the Revised Code and the assignment of rights to the 22819
department that are described in section 5101.595160.38 of the 22820
Revised Code.22821

       (2) Respond to an inquiry by the department regarding a claim 22822
for payment of a medical item or service that was submitted to the 22823
third party not later than three years after the date of the 22824
provision of such medical item or service;22825

       (3) Pay a claim described in division (A)(2) of this section;22826

       (4) Not deny a claim submitted by the department solely on 22827
the basis of the date of submission of the claim, type or format 22828
of the claim form, or a failure by the medical assistance 22829
recipient who is the subject of the claim to present proper 22830
documentation of coverage at the time of service, if both of the 22831
following are true:22832

       (a) The claim was submitted by the department not later than 22833
three years after the date of the provision of the medical item or 22834
service;22835

       (b) An action by the department to enforce its right of 22836
recovery under section 5101.585160.38 of the Revised Code on the 22837
claim was commenced not later than six years after the 22838
department's submission of the claim.22839

       (B) For purposes of the requirements in division (A) of this 22840
section, a third party shall treat a managed care organization as 22841
the department for a claim in which both of the following are 22842
true:22843

       (1) The individual who is the subject of the claim received a 22844
medical item or service through a managed care organization that 22845
has entered into a contract with the department of job and family 22846
serviceshealth care administration under section 5111.165165.0322847
of the Revised Code;22848

       (2) The department has assigned its right of recovery for the 22849
claim to the managed care organization.22850

       (C) The time limitations associated with the requirements in 22851
divisions (A)(2) and (A)(4) of this section apply only to 22852
submissions of claims to, and payments of claims by, a health 22853
insurer to which 42 U.S.C. 1396a(a)(25)(I) applies.22854

       Sec. 5101.574.        Sec. 5160.402.  No third party shall consider 22855
whether an individual is eligible for or receives medical 22856
assistance when either of the following applies:22857

       (A) The individual seeks to obtain a policy or enroll in a 22858
plan or program operated or administered by the third party;22859

       (B) The individual, or a person or governmental entity on the 22860
individual's behalf, seeks payment for a medical item or service 22861
provided to the individual.22862

       Sec. 5101.575.        Sec. 5160.403. (A) If a third party violates section 22863
5101.5725160.40, 5101.5735160.401, or 5101.5745160.402 of the 22864
Revised Code, a governmental entity that is responsible for 22865
issuing a license, certificate of authority, registration, or 22866
approval that authorizes the third party to do business in this 22867
state may impose a fine against the third party or deny, revoke, 22868
or terminate the third party's license, certificate, 22869
registration, or approval to do business in this state. The 22870
governmental entity shall determine which sanction is to be 22871
imposed. All actions to impose the sanction shall be taken in 22872
accordance with Chapter 119. of the Revised Code.22873

       (B) In addition to the sanctions that may be imposed under 22874
division (A) of this section for a violation of section 5101.57222875
5160.40, 5101.5735160.401, or 5101.5745160.402 of the Revised 22876
Code, the attorney general may petition a court of common pleas 22877
to enjoin the violation.22878

       Sec. 5101.591.        Sec. 5160.41. (A) Except as provided in division (B) 22879
of this section, the director of job and family serviceshealth 22880
care administration may adopt rules in accordance with Chapter 22881
119. of the Revised Code to implement sections 5101.5715160.3622882
to 5101.595160.41 of the Revised Code, including rules that 22883
specify what constitutes cooperating with efforts to obtain 22884
support or payments, or medical assistance payments, and when 22885
cooperation may be waived. 22886

       (B) The department shall adopt rules in accordance with 22887
Chapter 119. of the Revised Code to do all of the following:22888

       (1) For purposes of the definition of "information" in 22889
division (A) of section 5101.5715160.36 of the Revised Code, any 22890
data other than the data specified in that division that should 22891
be included in the definition.22892

       (2) For purposes of division (C)(1)(a) of section 5101.57222893
5160.40 of the Revised Code, the medium, format, and manner in 22894
which a third party must provide information to the department.22895

       (3) For purposes of division (C)(2) of section 5101.57222896
5160.40 of the Revised Code, the method by which a third party 22897
must provide the department with access to information.22898

       Sec. 5160.42.  Any application for the medicaid program or 22899
disability medical assistance program gives a right of subrogation 22900
to the department of health care administration for any workers' 22901
compensation benefits payable to a person who is subject to a 22902
support order, as defined in section 3119.01 of the Revised Code, 22903
on behalf of the applicant, to the extent of any payments made on 22904
the applicant's behalf under the medicaid program or disability 22905
medical assistance program. If the director of health care 22906
administration, in consultation with a child support enforcement 22907
agency and the administrator of the bureau of workers' 22908
compensation, determines that a person responsible for support 22909
payments to a medicaid recipient or disability medical assistance 22910
recipient is receiving workers' compensation, the director shall 22911
notify the administrator of the amount of the benefit to be paid 22912
to the department of health care administration.22913

       Sec. 5160.43.  As used in sections 5160.43 to 5160.46 of the 22914
Revised Code, "public medical assistance program" means the 22915
disability medical assistance program and medicaid program.22916

       As part of the procedure for the determination of whether 22917
benefits were incorrectly paid on behalf of public medical 22918
assistance program recipients, the director of health care 22919
administration shall furnish quarterly the name and social 22920
security number of each public medical assistance program 22921
recipient to the director of administrative services, the 22922
administrator of the bureau of workers' compensation, and each of 22923
the state's retirement boards. Within fourteen days after 22924
receiving the name and social security number of a public medical 22925
assistance program recipient, the director of administrative 22926
services, administrator, or board shall inform the auditor of 22927
state as to whether the recipient is receiving wages or benefits, 22928
the amount of any wages or benefits being received, the social 22929
security number, and the address of the recipient. The director of 22930
administrative services, administrator, boards, and any agent or 22931
employee of those officials and boards shall comply with the rules 22932
adopted under section 5160.65 of the Revised Code restricting the 22933
disclosure of information regarding public medical assistance 22934
program recipients. Any person who violates this provision shall 22935
thereafter be disqualified from acting as an agent or employee or 22936
in any other capacity under appointment or employment of any state 22937
board, commission, or agency.22938

       Sec. 5160.44.  As part of the procedure for the determination 22939
of whether benefits were incorrectly paid on behalf of a public 22940
medical assistance program recipient, the director of health care 22941
administration shall semiannually, at times determined jointly by 22942
the auditor of state and the tax commissioner, furnish to the tax 22943
commissioner in computer format the name and social security 22944
number of each public medical assistance program recipient. Within 22945
sixty days after receiving the name and social security number of 22946
a public medical assistance program recipient, the commissioner 22947
shall inform the auditor of state whether the recipient filed an 22948
Ohio individual income tax return, separate or joint, as provided 22949
by section 5747.08 of the Revised Code, for either or both of the 22950
two taxable years preceding the year in which the director 22951
furnished the names and social security numbers to the 22952
commissioner. If the recipient did so file, at the same time the 22953
commissioner shall also inform the auditor of state of the amount 22954
of the federal adjusted gross income as reported on such returns 22955
and of the addresses on such returns. The commissioner shall also 22956
advise the auditor of state whether such returns were filed on a 22957
joint basis, as provided in section 5747.08 of the Revised Code, 22958
in which case the federal adjusted gross income as reported may be 22959
that of the recipient or the recipient's spouse.22960

       If the auditor of state determines that further investigation 22961
is needed, the auditor of state may ask the commissioner to 22962
determine whether the public medical assistance program recipient 22963
filed income tax returns for any previous taxable years in which 22964
the recipient received medical assistance under a public medical 22965
assistance program and for which the tax department retains income 22966
tax returns. Within fourteen days of receipt of the request, the 22967
commissioner shall inform the auditor of state whether the 22968
recipient filed an individual income tax return for the taxable 22969
years in question, of the amount of the federal adjusted gross 22970
income as reported on such returns, of the addresses on such 22971
returns, and whether the returns were filed on a joint or separate 22972
basis.22973

       If the auditor of state determines that further investigation 22974
is needed of a public medical assistance program recipient who 22975
filed an Ohio individual income tax return, the auditor of state 22976
may request a certified copy of the Ohio individual income tax 22977
return or returns of that person for the taxable years described 22978
above, together with any other documents the commissioner has 22979
concerning the return or returns. Within fourteen days of receipt 22980
of such a request in writing, the commissioner shall forward the 22981
returns and documents to the auditor of state.22982

       The director of health care administration, county director 22983
of job and family services, county prosecutor, attorney general, 22984
auditor of state, or any agent or employee of those officials 22985
having access to any information or documents furnished by the 22986
commissioner pursuant to this section shall not divulge or use any 22987
such information except for the purpose of determining whether 22988
benefits were incorrectly paid on behalf of a public medical 22989
assistance program recipient, or for an audit, investigation, or 22990
prosecution, or in accordance with a proper judicial order. Any 22991
person who violates this provision shall thereafter be 22992
disqualified from acting as an agent or employee or in any other 22993
capacity under appointment or employment of any state or county 22994
board, commission, or agency.22995

       Sec. 5160.45.  The director of health care administration 22996
shall work with the tax commissioner to recover benefits 22997
incorrectly paid on behalf of public medical assistance program 22998
recipients from refunds of state income taxes that are payable to 22999
the recipients. Any benefit incorrectly paid, because of fraud or 23000
misrepresentation, as the result of an error by the recipient or 23001
by the agency making the payment, or for any other reason, may be 23002
collected under this section. Any reduction under section 5747.12 23003
or 5747.121 of the Revised Code to an income tax refund shall be 23004
made before a reduction under this section. No reduction shall be 23005
made under this section if the amount of the refund is less than 23006
twenty-five dollars after any reduction under section 5747.12 of 23007
the Revised Code. A reduction under this section shall be made 23008
before any part of the refund is contributed under section 23009
5747.113 of the Revised Code or is credited under section 5747.12 23010
of the Revised Code against tax due in any subsequent year.23011

       The director and the tax commissioner, by rules adopted in 23012
accordance with Chapter 119. of the Revised Code, shall establish 23013
procedures to implement this section. The procedures shall provide 23014
for notice to a public medical assistance program recipient and an 23015
opportunity for the recipient to be heard before the recipient's 23016
income tax refund is reduced.23017

       Sec. 5160.46.  The director of health care administration may 23018
enter into agreements with the federal government to recover 23019
benefits incorrectly paid on behalf of public medical assistance 23020
program recipients from refunds of federal income taxes that are 23021
payable to the recipients.23022

       Sec. 5160.50.  As used in sections 5160.50 to 5160.65 of the 23023
Revised Code:23024

       "Community control sanction" has the same meaning as in 23025
section 2929.01 of the Revised Code.23026

       "Fugitive felon" means an individual who is fleeing to avoid 23027
prosecution, or custody or confinement after conviction, under the 23028
laws of the place from which the individual is fleeing, for a 23029
crime or an attempt to commit a crime that is a felony under the 23030
laws of the place from which the individual is fleeing or, in the 23031
case of New Jersey, a high misdemeanor, regardless of whether the 23032
individual has departed from the individual's usual place of 23033
residence.23034

       "Information" means records as defined in section 149.011 of 23035
the Revised Code, any other documents in any format, and data 23036
derived from records and documents that are generated, acquired, 23037
or maintained by the department of health care administration, a 23038
county department of job and family services, or an entity 23039
performing duties on behalf of the department or a county 23040
department.23041

       "Law enforcement agency" means the state highway patrol, an 23042
agency that employs peace officers as defined in section 109.71 of 23043
the Revised Code, the adult parole authority, a county department 23044
of probation, a prosecuting attorney, the attorney general, 23045
similar agencies of other states, federal law enforcement 23046
agencies, and postal inspectors. "Law enforcement agency" includes 23047
the peace officers and other law enforcement officers employed by 23048
the agency.23049

       "Medical assistance provided under a government-funded 23050
program" means medical assistance provided under the medicaid 23051
program, children's health insurance program, children's buy-in 23052
program, disability medical assistance program, or any other 23053
program established under the Revised Code that the department of 23054
health care administration administers.23055

       "Post-release control sanction" has the same meaning as in 23056
section 2967.01 of the Revised Code.23057

       "Public medical assistance program" means the children's 23058
health insurance program, children's buy-in program, disability 23059
medical assistance program, and medicaid program.23060

       "Public medical assistance program recipient" means an 23061
applicant for, or recipient or former recipient of, a public 23062
medical assistance program.23063

       Sec. 5160.51.  Except as permitted by sections 5160.52 to 23064
5160.64 of the Revised Code or the rules adopted under section 23065
5160.65 of the Revised Code or required by federal law, no person 23066
or government entity shall solicit, disclose, receive, use, or 23067
knowingly permit, or participate in the use of any information 23068
regarding a public medical assistance program recipient for any 23069
purpose not directly connected with the administration of the 23070
public medical assistance program.23071

       Sec. 5160.52.  To the extent permitted by federal law, the 23072
department of health care administration and county departments of 23073
job and family services shall release information regarding a 23074
public medical assistance program recipient for purposes directly 23075
connected to the administration of the public medical assistance 23076
program to a government entity responsible for administering the 23077
public medical assistance program.23078

       Sec. 5160.53.  To the extent permitted by federal law, the 23079
department of health care administration and county departments of 23080
job and family services shall provide information regarding a 23081
public medical assistance program recipient to a law enforcement 23082
agency for the purpose of any investigation, prosecution, or 23083
criminal or civil proceeding relating to the administration of the 23084
public medical assistance program.23085

       Sec. 5160.54. (A) To the extent permitted by federal law and 23086
section 1347.08 of the Revised Code, the department of health care 23087
administration and county departments of job and family services 23088
shall provide access to information regarding a public medical 23089
assistance program recipient to all of the following:23090

       (1) The recipient;23091

       (2) The authorized representative;23092

       (3) The legal guardian of the recipient;23093

       (4) The attorney of the recipient, if the attorney has 23094
written authorization that complies with section 5160.57 of the 23095
Revised Code from the recipient.23096

       (B) The director of health care administration may adopt 23097
rules defining "authorized representative" for the purpose of this 23098
section.23099

       Sec. 5160.55. (A) To the extent permitted by federal law and 23100
subject to division (C) of this section, the department of health 23101
care administration and county departments of job and family 23102
services may release information regarding a public medical 23103
assistance program recipient as follows:23104

       (1) For purposes directly connected to the administration of 23105
a state, federal, or federally assisted program that provides cash 23106
or in-kind assistance or services directly to individuals, to a 23107
government entity responsible for administering the program;23108

       (2) For the purpose of protecting children, to a government 23109
entity responsible for administering a children's protective 23110
services program;23111

       (3) Subject to division (B) of this section, to any person or 23112
government entity to whom the recipient authorizes to receive the 23113
information by providing the department or county department 23114
voluntary, written authorization that complies with section 23115
5160.57 of the Revised Code.23116

       (B) The department and a county department shall release 23117
information pursuant to division (A)(3) of this section only in 23118
accordance with the public medical assistance program recipient's 23119
authorization. The department or county department shall provide, 23120
at no cost, a copy of each written authorization to the individual 23121
who signed it.23122

       (C) Neither the department nor a county department may 23123
release information under this section concerning a public medical 23124
assistance program recipient's receipt of medical assistance 23125
provided under a government-funded program unless all of the 23126
following conditions are met:23127

       (1) The release of information is for purposes directly 23128
connected to the administration of or provision of medical 23129
assistance provided under a government-funded program;23130

       (2) The information is released to persons or government 23131
entities that are subject to standards of confidentiality and 23132
safeguarding information substantially comparable to those 23133
established for medical assistance provided under a 23134
government-funded program;23135

       (3) The department or county department has obtained an 23136
authorization consistent with section 5160.57 of the Revised Code.23137

       Sec. 5160.56.  Information concerning the receipt of medical 23138
assistance provided under a government-funded program may be 23139
released only if the release complies with the more restrictive of 23140
the following:23141

       (A) Sections 5160.52 to 5160.55 of the Revised Code and rules 23142
adopted under section 5160.65 of the Revised Code;23143

       (B) The Health Insurance Portability and Accountability Act 23144
of 1996, 110 Stat. 1955, 42 U.S.C. 1320d, et seq., as amended, and 23145
regulations adopted by the United States department of health and 23146
human services to implement the act.23147

       Sec. 5160.57.  (A) For the purposes of sections 5160.54 and 23148
5160.55 of the Revised Code, an authorization shall be made on a 23149
form that uses language understandable to the average person and 23150
contains all of the following:23151

       (1) A description of the information to be used or disclosed 23152
that identifies the information in a specific and meaningful 23153
fashion;23154

       (2) The name or other specific identification of the person 23155
or class of persons authorized to make the requested use or 23156
disclosure;23157

       (3) The name or other specific identification of the person 23158
or governmental entity to which the information may be released;23159

       (4) A description of each purpose of the requested use or 23160
disclosure of the information;23161

       (5) The date on which the authorization expires or an event 23162
related either to the individual who is the subject of the request 23163
or to the purposes of the requested use or disclosure, the 23164
occurrence of which will cause the authorization to expire;23165

       (6) A statement that the information used or disclosed 23166
pursuant to the authorization may be disclosed by the recipient of 23167
the information and may no longer be protected from disclosure;23168

       (7) The signature of the individual or the individual's 23169
authorized representative and the date on which the authorization 23170
was signed;23171

       (8) If signed by an authorized representative, a description 23172
of the representative's authority to act for the individual;23173

       (9) A statement of the individual or authorized 23174
representative's right to prospectively revoke the written 23175
authorization in writing, along with one of the following:23176

       (a) A description of how the individual or authorized 23177
representative may revoke the authorization;23178

       (b) If the department of health care administration's privacy 23179
notice contains a description of how the individual or authorized 23180
representative may revoke the authorization, a reference to that 23181
privacy notice.23182

       (10) A statement that treatment, payment, enrollment, or 23183
eligibility for a public medical assistance program cannot be 23184
conditioned on signing the authorization unless the authorization 23185
is necessary for determining eligibility for the program.23186

       (B) When an individual requests information pursuant to 23187
section 5160.54 or 5160.55 of the Revised Code regarding the 23188
individual's receipt of a public medical assistance program and 23189
does not wish to provide a statement of purpose, the statement "at 23190
request of the individual" is a sufficient description for 23191
purposes of division (A)(4) of this section.23192

       Sec. 5160.58.  If cost savings are indicated in the report 23193
that the director of job and family services submitted to the 23194
general assembly under section 5101.272 of the Revised Code, the 23195
department of health care administration shall enter into any 23196
necessary agreements with the United States department of health 23197
and human services and neighboring states to join and participate 23198
as an active member in the public assistance reporting information 23199
system. The department may disclose information regarding a public 23200
medical assistance program recipient to the extent necessary to 23201
participate as an active member in the public assistance reporting 23202
information system.23203

       Sec. 5160.59.  On request of the department of health care 23204
administration or a county department of job and family services, 23205
a law enforcement agency shall provide information regarding 23206
public medical assistance program recipients to enable the 23207
department or county department to determine, for eligibility 23208
purposes, whether a recipient or a member of a recipient's 23209
assistance group is a fugitive felon or violating a condition of 23210
probation, a community control sanction, parole, or a post-release 23211
control sanction imposed under state or federal law.23212

       A county department may enter into a written agreement with a 23213
local law enforcement agency establishing procedures concerning 23214
access to information and providing for compliance with this 23215
section.23216

       The auditor of state shall prepare an annual report on the 23217
outcome of the agreements required by this section. The report 23218
shall include the number of fugitive felons, probation and parole 23219
violators, and violators of community control sanctions and 23220
post-release control sanctions apprehended during the immediately 23221
preceding year as a result of the exchange of information pursuant 23222
to this section. The auditor of state shall file the report with 23223
the governor, the president and minority leader of the senate, and 23224
the speaker and minority leader of the house of representatives. 23225
The department, county departments, and law enforcement agencies 23226
shall cooperate with the auditor of state's office in gathering 23227
the information needed for the report.23228

       Sec. 5160.60.  To the extent permitted by federal law, the 23229
department of health care administration and county departments of 23230
job and family services shall provide information, except 23231
information directly related to the receipt of medical assistance 23232
or medical services, regarding disability medical assistance 23233
program recipients to law enforcement agencies on request for the 23234
purposes of investigations, prosecutions, and criminal and civil 23235
proceedings that are within the scope of the law enforcement 23236
agencies' official duties.23237

       Sec. 5160.61.  Information about a public medical assistance 23238
program recipient shall be exchanged, obtained, or shared under 23239
sections 5160.59 and 5160.60 of the Revised Code only if the 23240
department of health care administration, county department of job 23241
and family services, or law enforcement agency requesting the 23242
information gives sufficient information to specifically identify 23243
the recipient. In addition to the recipient's name, identifying 23244
information may include the recipient's current or last known 23245
address, social security number, other identifying number, age, 23246
gender, physical characteristics, any information specified in an 23247
agreement entered into under section 5160.59 of the Revised Code, 23248
or any information considered appropriate by the department or 23249
county department.23250

       Sec. 5160.62.  The department of health care administration 23251
and its officers and employees are not liable in damages in a 23252
civil action for any injury, death, or loss to person or property 23253
that allegedly arises from the release of information in 23254
accordance with sections 5160.59 and 5160.60 of the Revised Code. 23255
This section does not affect any immunity or defense that the 23256
department and its officers and employees may be entitled to under 23257
another section of the Revised Code or the common law of this 23258
state, including section 9.86 of the Revised Code.23259

       Sec. 5160.63.  As used in this section, "employee" has the 23260
same meaning as in division (B) of section 2744.01 of the Revised 23261
Code.23262

       County departments of job and family services and their 23263
employees are not liable in damages in a civil action for any 23264
injury, death, or loss to person or property that allegedly arises 23265
from the release of information in accordance with sections 23266
5160.59 and 5160.60 of the Revised Code. This section does not 23267
affect any immunity or defense that the county departments and 23268
their employees may be entitled to under another section of the 23269
Revised Code or the common law of this state, including section 23270
2744.02 and division (A)(6) of section 2744.03 of the Revised 23271
Code.23272

       Sec. 5160.64.  To the extent permitted by federal law, the 23273
department of health care administration and county departments of 23274
job and family services shall provide access to information to the 23275
auditor of state acting pursuant to Chapter 117. or sections 23276
117.54, 117.55, 117.56, 5160.43, and 5160.44 of the Revised Code 23277
and to any other government entity authorized by federal law to 23278
conduct an audit of or similar activity involving a public medical 23279
assistance program.23280

       Sec. 5160.65.  The director of health care administration 23281
shall adopt rules in accordance with Chapter 119. of the Revised 23282
Code implementing sections 5160.50 to 5160.64 of the Revised Code 23283
and governing the custody, use, and preservation of the 23284
information generated or received by the department of health care 23285
administration, county departments of job and family services, 23286
other state and county entities, contractors, grantees, private 23287
entities, or officials participating in the administration of a 23288
public medical assistance program. The rules shall specify 23289
conditions and procedures for the release of information. The 23290
rules shall comply with applicable federal statutes and 23291
regulations. To the extent permitted by federal law:23292

       (A) The rules may permit providers of services or assistance 23293
under a public medical assistance program limited access to 23294
information that is essential for the providers to render services 23295
or assistance or to bill for services or assistance rendered. The 23296
department of aging, when investigating a complaint under section 23297
173.20 of the Revised Code, shall be granted any limited access 23298
permitted in the rules pursuant to division (A) of this section.23299

       (B) The rules may permit a contractor, grantee, or other 23300
state or county entity limited access to information that is 23301
essential for the contractor, grantee, or entity to perform 23302
administrative or other duties on behalf of the department or 23303
county department. A contractor, grantee, or entity given access 23304
to information pursuant to division (B) of this section is bound 23305
by the director's rules, and disclosure of the information by the 23306
contractor, grantee, or entity in a manner not authorized by the 23307
rules is a violation of section 5160.51 of the Revised Code.23308

       Sec. 5160.66. Whenever names, addresses, or other information 23309
relating to public medical assistance program recipients is held 23310
by any agency other than the department of health care 23311
administration or a county department of job and family services, 23312
that other agency shall adopt rules consistent with sections 23313
5160.50 to 5160.65 of the Revised Code to prevent the publication 23314
or disclosure of names, lists, or other information concerning 23315
those recipients.23316

       Sec. 5101.31.        Sec. 5160.67. Any record, data, pricing information, 23317
or other information regarding a drug rebate agreement or a 23318
supplemental drug rebate agreement for the medicaid program 23319
established under Chapter 5111. of the Revised Code or the 23320
disability medical assistance program established under section 23321
5115.10 of the Revised Code that the department of job and family 23322
serviceshealth care administration receives from a pharmaceutical 23323
manufacturer or creates pursuant to negotiation of the agreement 23324
is not a public record under section 149.43 of the Revised Code 23325
and shall be treated by the department as confidential 23326
information.23327

       Sec. 5160.70.  Not later than the last day of each July and 23328
January, the department of health care administration shall 23329
complete a report on the characteristics of the individuals who 23330
receive services through the programs operated by the department 23331
and the outcomes of the individuals' receipt of the services. The 23332
reports shall be for the six-month periods ending on the last days 23333
of June and December and shall include information regarding 23334
births to medicaid recipients.23335

       The department shall submit the reports to the speaker and 23336
minority leader of the house of representatives, the president and 23337
minority leader of the senate, the legislative budget officer, the 23338
director of budget and management, and each board of county 23339
commissioners. The department shall provide copies of the reports 23340
to any person or government entity on request.23341

       In designing the format for the reports, the department shall 23342
consult with individuals, organizations, and government entities 23343
interested in the programs operated by the department, so that the 23344
reports are designed to enable the general assembly and the public 23345
to evaluate the effectiveness of the programs and identify any 23346
needs that the programs are not meeting.23347

       Sec. 5160.71.  Whenever the federal government requires that 23348
the department of health care administration submit a report on a 23349
program that is operated by the department or is otherwise under 23350
the department's jurisdiction, the department shall prepare and 23351
submit the report in accordance with the federal requirements 23352
applicable to that report. To the extent possible, the department 23353
may coordinate the preparation and submission of a particular 23354
report with any other report, plan, or other document required to 23355
be submitted to the federal government, as well as with any report 23356
required to be submitted to the general assembly.23357

       Sec. 5160.75.  The department of health care administration 23358
shall create within the department the central pharmaceutical 23359
purchasing office. The office shall purchase, store, repackage, 23360
distribute, and dispense all drugs, pharmaceutical products, and 23361
related items needed by the departments of health, job and family 23362
services, mental health, mental retardation and developmental 23363
disabilities, rehabilitation and correction, and youth services 23364
and other state agencies for which the department of 23365
administrative services purchases supplies under section 125.05 of 23366
the Revised Code. The office also shall provide professional 23367
pharmacy consultation and drug information services to those 23368
departments and other state agencies.23369

       Notwithstanding section 125.05 of the Revised Code, purchases 23370
of drugs, pharmaceutical products, and related items under this 23371
section need not be purchased through the department of 23372
administrative services.23373

       Sec. 173.35.        Sec. 5160.80.  (A) As used in this section, "PASSPORT23374
administrative agency" means an entity under contract with the23375
department of aging to provide administrative services regarding23376
the PASSPORT program created under section 173.40 of the Revised23377
Code.23378

       (B) The department of aginghealth care administration shall 23379
administer the residential state supplement program under which 23380
the state supplements the supplemental security income payments 23381
received by aged, blind, or disabled adults under Title XVI of the 23382
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A., as 23383
amendedthe supplemental security income program. Residential 23384
state supplement payments shall be used for the provision of23385
accommodations, supervision, and personal care services to23386
supplemental security income recipients who the department23387
determines are at risk of needing institutional care.23388

       (C) For an individual to be eligible for residential state23389
supplement payments, all of the following must be the case:23390

       (1) Except as provided by division (G) of this section, the23391
individual must reside in one of the following:23392

       (a) An adult foster home certified under section 173.36 of23393
the Revised Code;23394

       (b) A home or facility, other than a nursing home or nursing23395
home unit of a home for the aging, licensed by the department of23396
health under Chapter 3721. or 3722. of the Revised Code and 23397
certified in accordance with standards established by the director 23398
of aging under division (D)(2) of this section;23399

       (c) A community alternative home licensed under section23400
3724.03 of the Revised Code and certified in accordance with 23401
standards established by the director of aging under division 23402
(D)(2) of this section;23403

       (d) A residential facility as defined in division23404
(A)(1)(d)(ii) of section 5119.22 of the Revised Code licensed by23405
the department of mental health and certified in accordance with 23406
standards established by the director of aging under division 23407
(D)(2) of this section;23408

       (e) An apartment or room used to provide community mental23409
health housing services certified by the department of mental23410
health under section 5119.611 of the Revised Code and approved by 23411
a board of alcohol, drug addiction, and mental health services23412
under division (A)(14) of section 340.03 of the Revised Code and 23413
certified in accordance with standards established by the director 23414
of aging under division (D)(2) of this section.23415

       (2) Effective July 1, 2000, a PASSPORT administrative agency23416
must have determined that the environment in which the individual23417
will be living while receiving the payments is appropriate for the23418
individual's needs. If the individual is eligible for supplemental 23419
security income payments or social security disability insurance 23420
benefits because of a mental disability, the PASSPORT23421
administrative agency shall refer the individual to a community 23422
mental health agency for the community mental health agency to 23423
issue in accordance with section 340.091 of the Revised Code a 23424
recommendation on whether the PASSPORT administrative agency 23425
should determine that the environment in which the individual will 23426
be living while receiving the payments is appropriate for the23427
individual's needs. Division (C)(2) of this section does not apply23428
to an individual receiving residential state supplement payments 23429
on June 30, 2000, until the individual's first eligibility23430
redetermination after that date.23431

       (3) The individual satisfies all eligibility requirements23432
established by rules adopted under division (D) of this section.23433

       (D)(1) The directorsdirector of aging and job and family 23434
serviceshealth care administration shall adopt rules in23435
accordance with section 111.15 of the Revised Code as necessary 23436
to implement the residential state supplement program.23437

       To the extent permitted by Title XVI of the "Social Security23438
Act,of 1935" and any other provision of federal law, the director 23439
of job and family serviceshealth care administration shall adopt 23440
rules establishing standards for adjusting the eligibility 23441
requirements concerning the level of impairment a person must have 23442
so that the amount appropriated for the program by the general 23443
assembly is adequate for the number of eligible individuals. The 23444
rules shall not limit the eligibility of disabled persons solely 23445
on a basis classifying disabilities as physical or mental. The23446
director of job and family serviceshealth care administration23447
also shall adopt rules that establish eligibility standards for23448
aged, blind, or disabled individuals who reside in one of the 23449
homes or facilities specified in division (C)(1) of this section 23450
but who, because of their income, do not receive supplemental 23451
security income payments. The rules may provide that these23452
individuals may include individuals who receive other types of 23453
benefits, including, social security disability insurance benefits 23454
provided under Title II of the "Social Security Act,of 1935" 49 23455
Stat. 620 (1935), 42 U.S.C.A. 401, as amended. Notwithstanding 23456
division (B) of this section, such payments may be made if funds 23457
are available for them.23458

       The director of aginghealth care administration shall adopt 23459
rules establishing the method to be used to determine the amount 23460
an eligible individual will receive under the program. The amount 23461
the general assembly appropriates for the program shall be a23462
factor included in the method that department establishes.23463

       (2) The director of aging shall adopt rules in accordance 23464
with Chapter 119. of the Revised Code establishing standards for 23465
certification of living facilities described in division (C)(1) of 23466
this section.23467

        The directors of aging and mental health shall enter into an 23468
agreement to certify facilities that apply for certification and 23469
meet the standards established by the director of aging under this 23470
division.23471

       (E) The county department of job and family services of the23472
county in which an applicant for the residential state supplement23473
program resides shall determine whether the applicant meets income23474
and resource requirements for the program.23475

       (F) The department of aginghealth care administration shall 23476
maintain a waiting list of any individuals eligible for payments 23477
under this section but not receiving them because moneys 23478
appropriated to the department for the purposes of this section 23479
are insufficient to make payments to all eligible individuals. An 23480
individual may apply to be placed on the waiting list even though 23481
the individual does not reside in one of the homes or facilities 23482
specified in division (C)(1) of this section at the time of 23483
application. The director of aginghealth care administration, by23484
rules adopted in accordance with Chapter 119. of the Revised 23485
Code, shall specify procedures and requirements for placing an23486
individual on the waiting list and priorities for the order in 23487
which individuals placed on the waiting list are to begin to 23488
receive residential state supplement payments. The rules 23489
specifying priorities may give priority to individuals placed on 23490
the waiting list on or after July 1, 2006, who receive 23491
supplemental security income benefits under Title XVI of the 23492
"Social Security Act," 86 Stat. 1475 (1972), 42 U.S.C. 1381, as 23493
amended. The rules shall not affect the place on the waiting list 23494
of any person who was on the list on July 1, 2006. The rules 23495
specifying priorities may also set additional priorities based on 23496
living arrangement, such as whether an individual resides in a 23497
facility listed in division (C)(1) of this section or has been 23498
admitted to a nursing facility.23499

       (G) An individual in a licensed or certified living23500
arrangement receiving state supplementation on November 15, 1990,23501
under former section 5101.531 of the Revised Code shall not become23502
ineligible for payments under this section solely by reason of the23503
individual's living arrangement as long as the individual remains23504
in the living arrangement in which the individual resided on23505
November 15, 1990.23506

       (H) The department of aginghealth care administration shall 23507
notify each person denied approval for payments under this section 23508
of the person's right to a hearing. On request, the hearing shall 23509
be provided by the department of job and family services in 23510
accordance with section 5101.355160.34 of the Revised Code.23511

       Sec. 173.351.        Sec. 5160.81.  (A) As used in this section:23512

       "Area agency on aging" has the same meaning as in section 23513
173.14 of the Revised Code.23514

       "Long-term care consultation program" means the program the 23515
department of aging is required to develop under section 173.42 of 23516
the Revised Code.23517

       "Long-term care consultation program administrator" or 23518
"administrator" means the department of aging or, if the 23519
department contracts with an area agency on aging or other entity 23520
to administer the long-term care consultation program for a 23521
particular area, that agency or entity.23522

       "Nursing facility" has the same meaning as in section 5111.2023523
5164.01 of the Revised Code.23524

       "Residential state supplement program" means the program 23525
administered pursuant to section 173.35 of the Revised Code.23526

       (B) Each month, each area agency on aging shall determine 23527
whether individuals who reside in the area that the area agency on 23528
aging serves and are on a waiting list for the residential state 23529
supplement program have been admitted to a nursing facility. If an 23530
area agency on aging determines that such an individual has been 23531
admitted to a nursing facility, the agency shall notify the 23532
long-term care consultation program administrator serving the area 23533
in which the individual resides about the determination. The 23534
administrator shall determine whether the residential state 23535
supplement program is appropriate for the individual and whether 23536
the individual would rather participate in the program than 23537
continue residing in the nursing facility. If the administrator 23538
determines that the residential state supplement program is 23539
appropriate for the individual and the individual would rather 23540
participate in the program than continue residing in the nursing 23541
facility, the administrator shall so notify the department of 23542
aginghealth care administration. On receipt of the notice from 23543
the administrator, the department of aginghealth care 23544
administration shall approve the individual's enrollment in the 23545
residential state supplement program in accordance with the 23546
priorities specified in rules adopted under division (F) of 23547
section 173.355160.80 of the Revised Code. Each quarter, the 23548
department of aginghealth care administration shall certify to 23549
the director of budget and management the estimated increase in 23550
costs of the residential state supplement program resulting from 23551
enrollment of individuals in the program pursuant to this 23552
section.23553

       (C) Not later than the last day of each calendar year, the 23554
director of aginghealth care administration shall submit to the 23555
general assembly a report regarding the number of individuals 23556
enrolled in the residential state supplement program pursuant to 23557
this section and the costs incurred and savings achieved as a 23558
result of the enrollments.23559

       Sec. 5160.99. Whoever violates section 5160.51 of the Revised 23560
Code is guilty of a misdemeanor of the first degree.23561

       Sec. 5161.01. The department of health care administration 23562
shall act as the single state agency to supervise the 23563
administration of the medicaid program. As the single state 23564
agency, the department shall comply with 42 C.F.R. 431.10(e). The 23565
department's rules governing medicaid are binding on other 23566
agencies that administer components of the medicaid program. No 23567
agency may establish, by rule or otherwise, a policy governing 23568
medicaid that is inconsistent with a medicaid policy established, 23569
in rule or otherwise, by the director of health care 23570
administration.23571

       Sec. 5111.102.        Sec. 5161.011. As used in this section, "state 23572
agency" has the same meaning as in section 9.23 of the Revised 23573
Code.23574

       No provision of Title LI of the Revised Code or any other law 23575
of this state that incorporates any provision of federal Medicaid23576
medicaid law, Title XIX of the Social Security Act, 79 Stat. 286 23577
(1965), 42 U.S.C. 1396, or that may be construed as requiring the 23578
state, a state agency, or any state official or employee to 23579
comply with that federal provision, shall be construed as 23580
creating a cause of action to enforce such state law beyond the 23581
causes of action available under federal law for enforcement of 23582
the provision of federal law.23583

       Sec. 5111.98.        Sec. 5161.02.  (A) The director of job and family 23584
serviceshealth care administration may do all of the following as 23585
necessary for the department of job and family serviceshealth 23586
care administration to fulfill the duties it has, as the single 23587
state agency for the medicaid program, under the "Medicare 23588
Prescription Drug, Improvement, and Modernization Act of 2003" 23589
Pub. L. No. 108-173, 117 Stat. 2066:23590

       (1) Adopt rules;23591

       (2) Assign duties to county departments of job and family 23592
services;23593

       (3) Make payments to the United States department of health 23594
and human services from appropriations made to the department of 23595
job and family serviceshealth care administration for this 23596
purpose.23597

       (B) Rules adopted under division (A)(1) of this section shall 23598
be adopted as follows:23599

       (1) If the rules concern the department's duties regarding 23600
service providers, in accordance with Chapter 119. of the Revised 23601
Code;23602

       (2) If the rules concern the department's duties concerning 23603
individuals' eligibility for services, in accordance with section 23604
111.15 of the Revised Code;23605

       (3) If the rules concern the department's duties concerning 23606
financial and operational matters between the department and 23607
county departments of job and family services, in accordance with 23608
section 111.15 of the Revised Code as if the rules were internal 23609
management rules.23610

       Sec. 5161.03.  The director of health care administration 23611
shall prepare and submit to the United States secretary of health 23612
and human services both of the following as necessary to 23613
accomplish the requirements of state law governing the medicaid 23614
program:23615

       (A) A state medicaid plan.23616

       (B) Amendments to the state medicaid plan.23617

       Sec. 5111.91.        Sec. 5161.05. The department of job and family23618
serviceshealth care administration may enter into contracts with 23619
one or more other state agencies or political subdivisions to have 23620
the state agency or political subdivision administer one or more23621
components of the medicaid program, or one or more aspects of a23622
component, under the department's supervision. A state agency or23623
political subdivision that enters into such a contract shall 23624
comply with the terms of the contract and any rules the director 23625
of job and family serviceshealth care administration has adopted23626
governing the component, or aspect of the component, that the23627
state agency or political subdivision is to administer, including23628
any rules establishing review, audit, and corrective action plan23629
requirements. A contract with a state agency shall be in the form23630
of an interagency agreement. The interagency agreement shall 23631
include a requirement for the state agency to submit an annual 23632
financing plan to the department.23633

       A state agency or political subdivision that enters into a23634
contract with the department under this section shall reimburse23635
the department for the nonfederal share of the cost to the23636
department of performing, or contracting for the performance of, a23637
fiscal audit of the component of the medicaid program, or aspect23638
of the component, that the state agency or political subdivision23639
administers if rules governing the component, or aspect of the23640
component, require that a fiscal audit be conducted.23641

       There is hereby created in the state treasury the medicaid23642
administrative reimbursement fund. The department shall use money23643
in the fund to pay for the nonfederal share of the cost of a23644
fiscal audit for which a state agency or political subdivision is23645
required by this section to reimburse the department. The23646
department shall deposit the reimbursements into the fund.23647

       Sec. 5111.911.        Sec. 5161.06. Any contract the department of job and 23648
family serviceshealth care administration enters into with the 23649
department of mental health or department of alcohol and drug 23650
addiction services under section 5111.915161.05 of the Revised 23651
Code is subject to the approval of the director of budget and 23652
management and shall require or specify all of the following:23653

        (A) In the case of a contract with the department of mental 23654
health, that section 5111.9125161.07 of the Revised Code be 23655
complied with;23656

        (B) In the case of a contract with the department of alcohol 23657
and drug addiction services, that section 5111.9135161.08 of the 23658
Revised Code be complied with;23659

        (C) How providers will be paid for providing the services;23660

        (D) The department of mental health's or department of 23661
alcohol and drug addiction services' responsibilities for 23662
reimbursing providers, including program oversight and quality 23663
assurance.23664

       Sec. 5111.912.        Sec. 5161.07. If the department of job and family 23665
serviceshealth care administration enters into a contract with 23666
the department of mental health under section 5111.915161.05 of 23667
the Revised Code, the department of mental health and boards of 23668
alcohol, drug addiction, and mental health services shall pay the 23669
nonfederal share of any medicaid payment to a provider for 23670
services under the component, or aspect of the component, the 23671
department of mental health administers.23672

       Sec. 5111.913.        Sec. 5161.08. If the department of job and family 23673
serviceshealth care administration enters into a contract with 23674
the department of alcohol and drug addiction services under 23675
section 5111.915161.05 of the Revised Code, the department of 23676
alcohol and drug addiction services and boards of alcohol, drug 23677
addiction, and mental health services shall pay the nonfederal 23678
share of any medicaid payment to a provider for services under the 23679
component, or aspect of the component, the department of alcohol 23680
and drug addiction services administers.23681

       Sec. 5111.90.        Sec. 5161.10.  (A) As used in sections 5111.9023682
5161.10 to 5111.935161.13 of the Revised Code:23683

       (1) "Political subdivision" means a municipal corporation,23684
township, county, school district, or other body corporate and23685
politic responsible for governmental activities only in a23686
geographical area smaller than that of the state.23687

       (2) "State agency" means every organized body, office, or23688
agency, other than the department of job and family services23689
health care administration, established by the laws of the state 23690
for the exercise of any function of state government.23691

       (B) To the extent permitted by Title XIX of the "Social23692
Security Act,of 1935" 79 Stat. 286 (1965), 42 U.S.C.A. 1396, as23693
amended, and regulations adopted under that title, the department23694
of job and family serviceshealth care administration may enter 23695
into contracts with political subdivisions to use funds of the 23696
political subdivision to pay the nonfederal share of expenditures 23697
under the medicaid program. The determination and provision of 23698
federal financial reimbursement to a subdivision entering into a 23699
contract under this section shall be determined by the department, 23700
subject to section 5111.925161.12 of the Revised Code, approval 23701
by the United States secretary of health and human services, and 23702
the availability of federal financial participation.23703

       Sec. 5111.92.        Sec. 5161.12.  (A)(1) Except as provided in division 23704
(B) of this section, if a state agency or political subdivision23705
administers one or more components of the medicaid program that23706
the United States department of health and human services23707
approved, and for which federal financial participation was23708
initially obtained, prior to January 1, 2002, or administers one23709
or more aspects of such a component, the department of job and23710
family serviceshealth care administration may retain or collect 23711
not more than ten per cent of the federal financial participation 23712
the state agency or political subdivision obtains through an 23713
approved, administrative claim regarding the component or aspect 23714
of the component. If the department retains or collects a 23715
percentage of such federal financial participation, the percentage 23716
the department retains or collects shall be specified in a 23717
contract the department enters into with the state agency or 23718
political subdivision under section 5111.915161.05 of the Revised 23719
Code.23720

       (2) Except as provided in division (B) of this section, if a23721
state agency or political subdivision administers one or more23722
components of the medicaid program that the United States23723
department of health and human services approved on or after23724
January 1, 2002, or administers one or more aspects of such a23725
component, the department of job and family serviceshealth care 23726
administration shall retain or collect not less than three and not 23727
more than ten per cent of the federal financial participation the 23728
state agency or political subdivision obtains through an approved, 23729
administrative claim regarding the component or aspect of the 23730
component. The percentage the department retains or collects shall 23731
be specified in a contract the department enters into with the 23732
state agency or political subdivision under section 5111.9123733
5161.05 of the Revised Code.23734

       (B) The department of job and family serviceshealth care 23735
administration may retain or collect a percentage of federal 23736
financial participation under divisions (A)(1) and (2) of this 23737
section only to the extent permitted by federal statutes and 23738
regulations.23739

       (C) All amounts the department retains or collects under this 23740
section shall be deposited into the health care services23741
administration fund created under section 5111.945161.15 of the 23742
Revised Code.23743

       Sec. 5111.93.        Sec. 5161.13.  The department of job and family 23744
serviceshealth care administration may retain or collect a 23745
percentage of the federal financial participation included in a 23746
supplemental medicaid payment to one or more medicaid providers 23747
owned or operated by a state agency or political subdivision that 23748
brings the payment to such provider or providers to the upper 23749
payment limit established by 42 C.F.R. 447.272. If the department 23750
retains or collects a percentage of that federal financial 23751
participation, the department shall adopt a rule under Chapter 23752
119. of the Revised Code specifying the percentage the department 23753
is to retain or collect. All amounts the department retains or 23754
collects under this section shall be deposited into the health 23755
care services administration fund created under section 5111.9423756
5161.15 of the Revised Code.23757

       Sec. 5111.94.        Sec. 5161.15.  (A) As used in this section, "vendor23758
offset" means a reduction of a medicaid payment to a medicaid23759
provider to correct a previous, incorrect medicaid payment to 23760
that provider.23761

       (B) There is hereby created in the state treasury the health23762
care services administration fund. Except as provided in division23763
(C) of this section, all the following shall be deposited into the 23764
fund:23765

       (1) Amounts deposited into the fund pursuant to sections23766
5111.925161.12 and 5111.935161.13 of the Revised Code;23767

       (2) The amount of the state share of all money the department 23768
of job and family serviceshealth care administration, in fiscal 23769
year 2003 and each fiscal year thereafter, recovers pursuant to a 23770
tort action under the department's right of recovery under 23771
section 5101.585160.38 of the Revised Code that exceeds the 23772
state share of all money the department, in fiscal year 2002, 23773
recovers pursuant to a tort action under that right of recovery;23774

       (3) Subject to division (D) of this section, the amount of23775
the state share of all money the department of job and family23776
serviceshealth care administration, in fiscal year 2003 and each 23777
fiscal year thereafter, recovers through audits of medicaid 23778
providers that exceeds the state share of all money the 23779
department, in fiscal year 2002, recovers through such audits;23780

       (4) Amounts from assessments on hospitals under section 23781
5112.065166.05 of the Revised Code and intergovernmental 23782
transfers by governmental hospitals under section 5112.075166.0623783
of the Revised Code that are deposited into the fund in 23784
accordance with the law;23785

       (5) Amounts that the department of education pays to the 23786
department of job and family serviceshealth care administration, 23787
if any, pursuant to an interagency agreement entered into under 23788
section 5111.7135163.303 of the Revised Code.23789

       (C) No funds shall be deposited into the health care services 23790
administration fund in violation of federal statutes or23791
regulations.23792

       (D) In determining under division (B)(3) of this section the23793
amount of money the department, in a fiscal year, recovers through23794
audits of medicaid providers, the amount recovered in the form of23795
vendor offset shall be excluded.23796

       (E) The director of job and family serviceshealth care 23797
administration shall use funds available in the health care 23798
services administration fund to pay for costs associated with the 23799
administration of the medicaid program.23800

       Sec. 5111.941.        Sec. 5161.16. (A) The medicaid revenue and 23801
collections fund is hereby created in the state treasury. Except 23802
as otherwise provided by statute or as authorized by the 23803
controlling board, both of the following shall be credited to the 23804
fund:23805

       (1) The nonfederal share of all medicaid-related revenues, 23806
collections, and recoveries;23807

       (2) The monthly premiums charged under the children's buy-in 23808
program pursuant to section 5101.52135167.37 of the Revised Code. 23809

       (B) The department of job and family serviceshealth care 23810
administration shall use money credited to the medicaid revenue 23811
and collections fund to pay for medicaid services and contracts 23812
and the children's buy-in program established under sections 23813
5101.5211 to 5101.5216 of the Revised Code.23814

       Sec. 5111.942.        Sec. 5161.17. (A) The prescription drug rebates fund 23815
is hereby created in the state treasury. Both of the following 23816
shall be credited to the fund:23817

       (1) The non-federalnonfederal share of all rebates paid by 23818
drug manufacturers to the department of job and family services23819
health care administration in accordance with a rebate agreement 23820
required by 42 U.S.C.A. 1396r-8;23821

       (2) The non-federalnonfederal share of all supplemental 23822
rebates paid by drug manufacturers to the department of job and 23823
family serviceshealth care administration in accordance with the 23824
supplemental drug rebate program established under section 23825
5111.0815163.26 of the Revised Code.23826

       (B) The department of job and family serviceshealth care 23827
administration shall use money credited to the prescription drug 23828
rebates fund to pay for medicaid services and contracts.23829

       Sec. 5111.943.        Sec. 5161.18. (A) The health care - federal fund is 23830
hereby created in the state treasury. All of the following shall 23831
be credited to the fund:23832

       (1) Funds that division (B) of section 5112.185166.12 of the 23833
Revised Code requires be credited to the fund;23834

       (2) The federal share of all rebates paid by drug 23835
manufacturers to the department of job and family serviceshealth 23836
care administration in accordance with a rebate agreement required 23837
by 42 U.S.C. 1396r-8;23838

       (3) The federal share of all supplemental rebates paid by 23839
drug manufacturers to the department of job and family services23840
health care administration in accordance with the supplemental 23841
drug rebate program established under section 5111.0815163.26 of 23842
the Revised Code;23843

       (4) Except as otherwise provided by statute or as authorized 23844
by the controlling board, the federal share of all other 23845
medicaid-related revenues, collections, and recoveries.23846

       (B) All money credited to the health care - federal fund 23847
pursuant to division (B) of section 5112.185166.12 of the Revised 23848
Code shall be used solely for distributing funds to hospitals 23849
under section 5112.085166.07 of the Revised Code. The department 23850
of job and family serviceshealth care administration shall use 23851
all other money credited to the fund to pay for other medicaid 23852
services and contracts.23853

       Sec. 5111.915.        Sec. 5161.25.  (A) The department of job and family 23854
serviceshealth care administration shall enter into an agreement 23855
with the department of administrative services for the department 23856
of administrative services to contract through competitive 23857
selection pursuant to section 125.07 of the Revised Code with a 23858
vendor to perform an assessment of the data collection and data 23859
warehouse functions of the medicaid data warehouse system, 23860
including the ability to link the data sets of all agencies 23861
serving medicaid recipients. 23862

       The assessment of the data system shall include functions 23863
related to fraud and abuse detection, program management and 23864
budgeting, and performance measurement capabilities of all 23865
agencies serving medicaid recipients, including the departments of 23866
aging, alcohol and drug addiction services, health, job and family 23867
serviceshealth care administration, mental health, and mental 23868
retardation and developmental disabilities.23869

       The department of administrative services shall enter into 23870
this contract within thirty days after the effective date of this 23871
sectionSeptember 29, 2005. The contract shall require the vendor 23872
to complete the assessment within ninety days after the effective 23873
date of this sectionSeptember 29, 2005.23874

       A qualified vendor with whom the department of administrative 23875
services contracts to assess the data system shall also assist the 23876
medicaid agencies in the definition of the requirements for an 23877
enhanced data system or a new data system and assist the 23878
department of administrative services in the preparation of a 23879
request for proposal to enhance or develop a data system.23880

       (B) Based on the assessment performed pursuant to division 23881
(A) of this section, the department of administrative services 23882
shall seek a qualified vendor through competitive selection 23883
pursuant to section 125.07 of the Revised Code to develop or 23884
enhance a data collection and data warehouse system for the 23885
department of job and family serviceshealth care administration23886
and all agencies serving medicaid recipients.23887

       Within ninety days after the effective date of this section23888
September 29, 2005, the department of job and family services23889
health care administration shall seek enhanced federal funding for 23890
ninety per cent of the funds required to establish or enhance the 23891
data system. The department of administrative services shall not 23892
award a contract for establishing or enhancing the data system 23893
until the department of job and family serviceshealth care 23894
administration receives approval from the secretary of the United 23895
States department of health and human services for the ninety per 23896
cent federal match.23897

       Sec. 5111.10.        Sec. 5161.30.  The director of job and family 23898
serviceshealth care administration may conduct reviews of the 23899
medicaid program. The reviews may include physical inspections of 23900
records and sites where medicaid-funded services are provided and 23901
interviews of providers and recipients of the services. If the 23902
director determines pursuant to a review that a person or 23903
government entity has violated a rule governing the medicaid 23904
program, the director may establish a corrective action plan for 23905
the violator and impose fiscal, administrative, or both types of 23906
sanctions on the violator in accordance with rules governing the 23907
medicaid program. 23908

       Sec. 5111.09.        Sec. 5161.32.  On or before the first day of January 23909
of each year, the department of job and family serviceshealth 23910
care administration shall submit to the speaker and minority 23911
leader of the house of representatives and the president and 23912
minority leader of the senate, and shall make available to the 23913
public, a report on the effectiveness of the Ohio works first 23914
program established under Chapter 5107. of the Revised Code and23915
the medical assistancemedicaid program established under this 23916
chapter in meeting the health care needs of low-income pregnant 23917
women, infants, and children. The report shall include: the 23918
estimated number of persons eligible for health care services to 23919
pregnant women, infants, and children under the programs; the 23920
actual number of eligible persons served; the number of prenatal,23921
postpartum, and child health visits; a report on birth outcomes,23922
including a comparison of low-birthweight births and infant23923
mortality rates of program participants with the general female23924
child-bearing and infant population in this state; and a23925
comparison of the prenatal, delivery, and child health costs of23926
the programs with such costs of similar programs in other states,23927
where available.23928

       Sec. 5111.091.        Sec. 5161.33.  Not later than the first day of each 23929
calendar quarter, the director of job and family serviceshealth 23930
care administration shall submit a report to the president and23931
minority leader of the senate, speaker and minority leader of23932
the house of representatives, and the chairpersons of the 23933
committees of the senate and house of representatives that hear 23934
bills making biennial appropriations on the establishment and23935
implementation of programs designed to control the increase of 23936
the cost of the medicaid program, increase the efficiency of the 23937
medicaid program, and promote better health outcomes.23938

       The report shall include information regarding all of the 23939
following:23940

       (A) Provider network management;23941

       (B) Electronic claims submission and payment systems;23942

       (C) Limited provider contracts and payments based on 23943
performance;23944

       (D) Efforts to enforce third party liability;23945

       (E) Implementation of the medicaid information technology 23946
system;23947

       (F) Expansion of the medicaid data warehouse and decision 23948
support system;23949

       (G) Development of infrastructure policies for electronic 23950
health records and e-prescribing.23951

       Sec. 5111.01.        Sec. 5162.01. As used in this chapter, "medical 23952
assistance program" or "medicaid" means the program that is 23953
authorized by this chapter and provided by the department of job 23954
and family services under this chapter, Title XIX of the "Social23955
Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1396, as amended, 23956
and the waivers of Title XIX requirements granted to the23957
department by the centers for medicare and medicaid services of 23958
the United States department of health and human services.23959

       The department of job and family services shall act as the23960
single state agency to supervise the administration of the23961
medicaid program. As the single state agency, the department shall 23962
comply with 42 C.F.R. 431.10(e). The department's rules governing 23963
medicaid are binding on other agencies that administer components 23964
of the medicaid program. No agency may establish, by rule or 23965
otherwise, a policy governing medicaid that is inconsistent with a 23966
medicaid policy established, in rule or otherwise, by the director 23967
of job and family services.23968

       (A) The department of job and family serviceshealth care 23969
administration may provide medical assistance under the medicaid 23970
program as long as federal funds are provided for such 23971
assistance, to the following:23972

       (1)(A) Families with children that meet either of the 23973
following conditions:23974

       (a) The family meets the income, resource, and family23975
composition requirements in effect on July 16, 1996, for the23976
former aid to dependent children program as those requirements23977
were established by Chapter 5107. of the Revised Code, federal23978
waivers granted pursuant to requests made under former section23979
5101.09 of the Revised Code, and rules adopted by the department23980
for that former program or any changes the department makes to 23981
those requirements in accordance with paragraph (a)(2) of section 23982
114 of the "Personal Responsibility and Work Opportunity 23983
Reconciliation Act of 1996," 110 Stat. 2177, 42 U.S.C.A. 1396u-1,23984
for the purpose of implementing section 5111.0195126.05 of the 23985
Revised Code. An adult loses eligibility for medicaid under 23986
division (A)(1)(a) of this section pursuant to division (D) of 23987
section 5107.16 of the Revised Code.23988

       (b) The family does not meet the requirements specified in23989
division (A)(1)(a) of this section but is eligible for medicaid 23990
pursuant to section 5101.18 of the Revised Code.23991

       (2)(B) Aged, blind, and disabled persons who meet either of23992
the following conditions:23993

       (a)(1) Receive federal aidbenefits under Title XVI of the23994
"Social Security Act,"the supplemental security income program or 23995
are eligible for but are not receiving such aidSSI benefits,23996
provided that the income from all other sources for individuals23997
with independent living arrangements shall not exceed one hundred23998
seventy-five dollars per month. The income standards hereby23999
established shall be adjusted annually at the rate that is used by24000
the United States department of health and human services to24001
adjust the amounts payable under Title XVIthe SSI program.24002

       (b)(2) Do not receive aid under Title XVIsupplemental 24003
security income benefits, but meet any of the following criteria:24004

       (i)(a) Would be eligible to receive such aidfor SSI 24005
benefits, except that their income, other than that excluded from 24006
consideration as income under Title XVIfor the SSI program, 24007
exceeds the maximum under division (A)(2)(a)(B)(1) of this 24008
section, and incurred expenses for medical care, as determined 24009
under federal regulations applicable to section 209(b) of the24010
"Social Security Amendments of 1972," 86 Stat. 1381, 42 U.S.C.A. 24011
1396a(f), as amended, equal or exceed the amount by which their 24012
income exceeds the maximum under division (A)(2)(a)(B)(1) of this24013
section;24014

       (ii)(b) Received aid for the aged, aid to the blind, or aid24015
for the permanently and totally disabled prior to January 1, 1974, 24016
and continue to meet all the same eligibility requirements;24017

       (iii) Are eligible for medicaid pursuant to section 5101.18 24018
of the Revised Code(c) Lost eligibility for SSI benefits due to a 24019
general increase in old-age, survivors, and disability insurance 24020
benefits under Title II of the Social Security Act of 1935.24021

       (3)(C) Persons to whom federal law requires, as a condition24022
of state participation in the medicaid program, that medicaid be 24023
provided;24024

       (4)(D) Persons under age twenty-one who meet the income24025
requirements for the Ohio works first program established under24026
Chapter 5107. of the Revised Code but do not meet other24027
eligibility requirements for the program. The director shall24028
adopt rules in accordance with Chapter 119. of the Revised Code24029
specifying which Ohio works first requirements shall be waived for24030
the purpose of providing medicaid eligibility under division24031
(A)(4) of this section.24032

       (B) If sufficient funds are appropriated for the medicaid 24033
program, the department may provide medical assistance under the 24034
medicaid program to persons in groups designated by federal law24035
as groups to which a state, at its option, may provide medical 24036
assistance under the medicaid program.24037

       (C) The department may expand eligibility for the medicaid 24038
program to include individuals under age nineteen with family24039
incomes at or below one hundred fifty per cent of the federal24040
poverty guidelines, except that the eligibility expansion shall24041
not occur unless the department receives the approval of the24042
federal government. The department may implement the eligibility24043
expansion authorized under this division on any date selected by24044
the department, but not sooner than January 1, 1998.24045

       (D) In addition to any other authority or requirement to24046
adopt rules under this chapter, the director may adopt rules in24047
accordance with section 111.15 of the Revised Code as the director24048
considers necessary to establish standards, procedures, and other24049
requirements regarding the provision of medical assistance under 24050
the medicaid program. The rules may establish requirements to be 24051
followed in applying for medicaid, making determinations of 24052
eligibility for medicaid, and verifying eligibility for medicaid. 24053
The rules may include special conditions as the department 24054
determines appropriate for making applications, determining 24055
eligibility, and verifying eligibility for any medical assistance 24056
that the department may provide under the medicaid program 24057
pursuant to division (C) of this section and section 5111.014 or 24058
5111.019 of the Revised Code.24059

       Sec. 5162.02. If funds are appropriated for such purpose by 24060
the general assembly, the department of health care administration 24061
may expand eligibility for the medicaid program to persons in 24062
groups designated by federal law as groups to which a state, at 24063
its option, may provide medical assistance under the medicaid 24064
program.24065

       Sec. 5162.03. The department of health care administration 24066
may expand eligibility for the medicaid program to individuals 24067
under nineteen years of age with family incomes at or below one 24068
hundred fifty per cent of the federal poverty guidelines, except 24069
that the eligibility expansion shall not occur unless the 24070
department receives the approval of the United States department 24071
of health and human services. The department may implement the 24072
eligibility expansion authorized by this section on any date 24073
selected by the department.24074

       Sec. 5111.014.        Sec. 5162.04.  (A) The director of job and family24075
serviceshealth care administration shall submit to the United 24076
States secretary of health and human services an amendment to the 24077
state medicaid plan to make an individual who meets all of the 24078
following requirements eligible for medicaid:24079

       (1) The individual is pregnant;24080

       (2) The individual's family income does not exceed two 24081
hundred per cent of the federal poverty guidelines;24082

       (3) The individual satisfies all relevant requirements 24083
established by rules adopted under division (D) of section 5111.0124084
5162.20 of the Revised Code.24085

       (B) If approved by the United States secretary of health and 24086
human services, the director of job and family serviceshealth 24087
care administration shall implement the medicaid plan amendment 24088
submitted under division (A) of this section as soon as possible 24089
after receipt of notice of the approval, but not sooner than 24090
January 1, 2008.24091

       Sec. 5111.019.        Sec. 5162.05.  The director of job and family24092
serviceshealth care administration shall submit to the United 24093
States secretary of health and human services an amendment to the 24094
state medicaid plan to make an individual eligible for medicaid 24095
who meets all of the following requirements:24096

       (A) The individual is the parent of a child under nineteen24097
years of age and resides with the child;24098

       (B) The individual's family income does not exceed ninety 24099
per cent of the federal poverty guidelines;24100

       (C) The individual is not otherwise eligible for medicaid;24101

       (D) The individual satisfies all relevant requirements24102
established by rules adopted under division (D) of section 5111.0124103
5162.20 of the Revised Code.24104

       Sec. 5111.0111.        Sec. 5162.06.  (A) The director of job and family24105
serviceshealth care administration shall submit to the United 24106
States secretary of health and human services an amendment to the 24107
state medicaid plan to implement 42 U.S.C. 1396a 24108
(a)(10)(A)(ii)(XVII) to make an individual who meets all of the 24109
following requirements eligible for medicaid:24110

       (1) The individual is under twenty-one years of age;24111

       (2) The individual was in foster care under the 24112
responsibility of the state on the individual's eighteenth 24113
birthday;24114

       (3) Foster care maintenance payments or independent living 24115
services were furnished under a program funded under Title IV-E 24116
of the Social Security Act of 1935 on the individual's behalf 24117
before the individual attained eighteen years of age;24118

       (4) The individual meets all other applicable eligibility 24119
requirements established in rules adopted under section 5111.01124120
5162.20 of the Revised Code.24121

       (B) If approved by the United States secretary of health and24122
human services, the director of job and family serviceshealth 24123
care administration shall implement the medicaid plan amendment 24124
submitted under this section beginning January 1, 2008.24125

       Sec. 5111.0113.        Sec. 5162.07.  Children who are in the temporary or 24126
permanent custody of a certified public or private nonprofit 24127
agency or institution or in adoptions subsidized under division 24128
(B) of section 5153.163 of the Revised Code are eligible for 24129
medical assistance through the medicaid program established under 24130
section 5111.01 of the Revised Code.24131

       Sec. 5111.0110.        Sec. 5162.08.  (A) The director of job and family24132
serviceshealth care administration shall submit to the United 24133
States secretary of health and human services an amendment to the 24134
state medicaid plan to implement the "Breast and Cervical Cancer 24135
Prevention and Treatment Act of 2000," 114 Stat. 1381, 42 U.S.C.A. 24136
1396a, as amended, to provide medical assistance to women who meet 24137
all of the following requirements:24138

       (1) Are under age sixty-five;24139

       (2) Are not otherwise eligible for medicaid;24140

       (3) Have been screened for breast and cervical cancer under24141
the centers for disease control and prevention breast and cervical24142
cancer early detection program established under 42 U.S.C.A. 300k24143
in accordance with 42 U.S.C.A. 300n;24144

       (4) Need treatment for breast or cervical cancer;24145

       (5) Are not otherwise covered under creditable coverage, as24146
defined in 42 U.S.C.A. 300gg(c).24147

       (B) If the United States secretary of health and human24148
services approves the state medicaid plan amendment submitted24149
under division (A) of this section, the director of job and family24150
serviceshealth care administration shall implement the amendment. 24151
The medical assistance provided under the amendment shall be 24152
limited to medical assistance provided during the period in which 24153
a woman who meets the requirements of division (A) of this section 24154
requires treatment for breast or cervical cancer.24155

       Sec. 5111.0115.        Sec. 5162.09.  (A) The department of job and family24156
serviceshealth care administration may provide medical assistance 24157
under the medicaid program, as long as federal funds are provided 24158
for such assistance, to each former participant of the Ohio works 24159
first program established under Chapter 5107. of the Revised Code 24160
who meets all of the following requirements:24161

       (1) Is ineligible to participate in Ohio works first solely24162
as a result of increased income due to employment;24163

       (2) Is not covered by, and does not have access to, medical 24164
insurance coverage through the employer with benefits comparable 24165
to those provided under this section, as determined in accordance 24166
with rules adopted by the director of job and family services24167
health care administration under division (B) of this section;24168

       (3) Meets any other requirement established by rule adopted 24169
under division (B) of this section.24170

       (B) The director of job and family serviceshealth care 24171
administration shall adopt such rules under Chapter 119. of the 24172
Revised Code as are necessary to implement and administer the 24173
medical assistancemedicaid program under this section.24174

       (C) A person seeking to participate in a program of medical 24175
assistance underthe medicaid program pursuant to this section 24176
shall apply to the county department of job and family services in 24177
the county in which the applicant resides. The application shall 24178
be made on a form prescribed by the department of job and family 24179
serviceshealth care administration and furnished by the county 24180
department.24181

       (D) If the county department of job and family services24182
determines that a person is eligible to receive medical assistance24183
medicaid under this section, the department shall provide 24184
assistance, to the same extent and in the same manner as medical 24185
assistancemedicaid is provided to a person eligible for medical 24186
assistancemedicaid pursuant to division (A)(1)(a) of section 24187
5111.015162.01 of the Revised Code, for no longer than twelve 24188
months, beginning the month after the date the participant's 24189
eligibility for Ohio works first is terminated.24190

       Sec. 5111.70.        Sec. 5162.10.  (A) As used in sections 5111.7024191
5162.10 to 5111.70115162.1011 of the Revised Code:24192

       "Applicant" means an individual who applies to participate 24193
in the medicaid buy-in for workers with disabilities program.24194

       "Earned income" has the meaning established by rules adopted 24195
under section 5111.7085162.108 of the Revised Code.24196

       "Employed individual with a medically improved disability" 24197
has the same meaning as in 42 U.S.C. 1396d(v).24198

       "Family" means an applicant or participant and the spouse 24199
and dependent children of the applicant or participant. If an 24200
applicant or participant is under eighteen years of age, "family" 24201
also means the parents of the applicant or participant.24202

       "Federal poverty guidelines" has the same meaning as in 24203
section 5101.46 of the Revised Code.24204

       "Health insurance" has the meaning established by rules 24205
adopted under section 5111.7085162.108 of the Revised Code.24206

       "Income" means earned income and unearned income.24207

       "Participant" means an individual who has been determined 24208
eligible for the medicaid buy-in for workers with disabilities 24209
program and is participating in the program.24210

       "Resources" has the meaning established by rules adopted 24211
under section 5111.7085162.108 of the Revised Code.24212

       "Spouse" has the meaning established in rules adopted under 24213
section 5111.7085162.108 of the Revised Code.24214

       "Supplemental security income program" means the program 24215
established under Title XVI of the "Social Security Act," 86 Stat. 24216
1329 (1972), 42 U.S.C. 1381, as amended.24217

       "Medicaid buy-in for workers with disabilities program" 24218
means the component of the medicaid program established under 24219
sections 5111.705162.10 to 5111.70115162.1011 of the Revised 24220
Code.24221

       "Unearned income" has the meaning established by rules 24222
adopted under section 5111.7085162.108 of the Revised Code.24223

       (B) Not later than one hundred eighty days after the 24224
effective date of this sectionSeptember 29, 2007, the director 24225
of job and family serviceshealth care administration shall 24226
submit to the United States secretary of health and human 24227
services an amendment to the state medicaid plan and any 24228
federal waiver necessary to establish the medicaid buy-in for 24229
workers with disabilities program in accordance with 42 U.S.C. 24230
1396a(a) (10)(A)(ii)(XV) and (XVI) and sections 5111.705162.1024231
to 5111.70115162.1011 of the Revised Code. The director shall 24232
implement sections 5111.7015162.101 to 5111.70115162.1011 of 24233
the Revised Code if the amendment and, if needed, federal 24234
waiver are approved.24235

       Sec. 5111.701.        Sec. 5162.101.  Under the medicaid buy-in for 24236
workers with disabilities program, an individual who does all of 24237
the following in accordance with rules adopted under section 24238
5111.7085162.108 of the Revised Code qualifies for medical 24239
assistance under the medicaid program:24240

       (A) Applies for the medicaid buy-in for workers with 24241
disabilities program;24242

       (B) Provides satisfactory evidence of all of the following:24243

       (1) That the individual is at least sixteen years of age and 24244
under sixty-five years of age;24245

       (2) Except as provided in section 5111.7065162.106 of the 24246
Revised Code, that one of the following applies to the 24247
individual:24248

       (a) The individual is considered disabled for the purpose of 24249
the supplemental security income program, regardless of whether 24250
the individual receives supplemental security income benefits, and 24251
the individual has earnings from employment.24252

       (b) The individual is an employed individual with a medically 24253
improved disability.24254

       (3) That the value of the individual's resources, less 24255
amounts disregarded pursuant to rules adopted under section 24256
5111.7085162.108 of the Revised Code, does not exceed the amount 24257
provided for by section 5111.7025162.102 of the Revised Code;24258

       (4) That the individual's income, less amounts disregarded 24259
pursuant to section 5111.7035162.103 of the Revised Code, does 24260
not exceed two hundred fifty per cent of the federal poverty 24261
guidelines;24262

       (5) That the individual meets the additional eligibility 24263
requirements for the medicaid buy-in for workers with disabilities 24264
program that the director of job and family services establishes24265
are established in rules adopted under section 5111.7085162.10824266
of the Revised Code.24267

       (C) To the extent required by section 5111.7045162.104 of 24268
the Revised Code, pays the premium established under that 24269
section.24270

       Sec. 5111.702.        Sec. 5162.102.  (A) Except as provided in division 24271
(B) of this section, the maximum value of resources, less amounts 24272
disregarded pursuant to rules adopted under section 5111.70824273
5162.108 of the Revised Code, that an individual may have 24274
without the individual exceeding the resource eligibility limit 24275
for the medicaid buy-in for workers with disabilities program 24276
shall not exceed ten thousand dollars.24277

       (B) Each calendar year, the director of job and family 24278
serviceshealth care administration shall adjust the resource 24279
eligibility limit specified in division (A) of this section by 24280
the change in the consumer price index for all items for all 24281
urban consumers for the previous calendar year, as published by 24282
the United States bureau of labor statistics. The annual 24283
adjustment shall go into effect on the earliest date possible.24284

       Sec. 5111.703.        Sec. 5162.103.  For the purpose of determining 24285
whether an individual is within the income eligibility limit for 24286
the medicaid buy-in for workers with disabilities program, all 24287
of the following apply:24288

       (A) Twenty thousand dollars of the individual's earned 24289
income shall be disregarded.24290

       (B) No amount that the individual's employer pays to obtain 24291
health insurance for one or more members of the individual's 24292
family, including any amount of a premium established under 24293
section 5111.7045162.104 of the Revised Code that the employer 24294
pays, shall be treated as the individual's income.24295

       (C) Any other amounts, if any, specified in rules adopted 24296
under section 5111.7085162.108 of the Revised Code shall be 24297
disregarded from the individual's earned income, unearned 24298
income, or both.24299

       Sec. 5111.704.        Sec. 5162.104. An individual whose income exceeds 24300
one hundred fifty per cent of the federal poverty guidelines 24301
shall pay an annual premium as a condition of qualifying for the 24302
medicaid buy-in for workers with disabilities program. The amount 24303
of the premium shall be determined as follows:24304

       (A) Subtract one hundred fifty per cent of the federal 24305
poverty guidelines, as applicable for a family size equal to the 24306
size of the individual's family, from the amount of the income of 24307
the individual's family;24308

       (B) Subtract an amount specified in rules adopted under 24309
section 5111.7085162.108 of the Revised Code from the difference 24310
determined under division (A) of this section;24311

       (C) Multiply the difference determined under division (B) of 24312
this section by one tenth.24313

       Sec. 5111.705.        Sec. 5162.105. No individual shall be denied 24314
eligibility for the medicaid buy-in for workers with disabilities 24315
program on the basis that the individual receives services under 24316
a home and community-based services medicaid waiver component as 24317
defined in section 5111.8515163.51 of the Revised Code.24318

       Sec. 5111.706.        Sec. 5162.106. An individual participating in the 24319
medicaid buy-in for workers with disabilities program may 24320
continue to participate in the program for up to six months even 24321
though the individual ceases to have earnings from employment or 24322
to be an employed individual with a medically improved disability 24323
due to ceasing to be employed if the individual continues to meet 24324
all other eligibility requirements for the program.24325

       Sec. 5111.707.        Sec. 5162.107.  If the United States secretary of 24326
health and human services requires that a provision in the 24327
amendment to the state medicaid plan or the federal waiver 24328
request submitted under section 5111.705162.10 of the Revised 24329
Code be changed or removed in order for the secretary to approve 24330
the amendment or waiver or to avoid an extended delay in the 24331
secretary's approval, the director of job and family services24332
health care administration shall make the change or removal. The 24333
change or removal may cause the medicaid buy-in for workers with 24334
disabilities program to include a provision that is inconsistent 24335
with sections 5111.705162.10 to 5111.7065162.106 of the Revised 24336
Code. Such a change or removal shall be made only to the extent 24337
necessary to obtain the United States secretary's approval or 24338
avoid an extended delay in the secretary's approval and shall be 24339
reflected in rules adopted under section 5111.7085162.108 of the 24340
Revised Code.24341

       Sec. 5111.708.        Sec. 5162.108. (A) The director of job and family 24342
serviceshealth care administration, after consulting with the 24343
medicaid buy-in advisory council, shall adopt rules in accordance 24344
with Chapter 119. of the Revised Code as necessary to implement 24345
the medicaid buy-in for workers with disabilities program. The 24346
rules shall do all of the following:24347

       (1) Specify assets, asset values, and amounts to be 24348
disregarded in determining asset and income eligibility limits for 24349
the program;24350

       (2) Establish meanings for the terms "earned income," "health 24351
insurance," "resources," "spouse," and "unearned income";24352

       (3) Establish additional eligibility requirements for the 24353
program that must be established for the United States secretary 24354
of health and human services to approve the program;24355

       (4) For the purpose of division (B) of section 5111.70424356
5162.104 of the Revised Code, specify an amount to be subtracted 24357
from the difference determined under division (A) of that 24358
section.24359

       (B) The director, after consulting with the medicaid buy-in 24360
advisory council, may adopt rules in accordance with Chapter 119. 24361
of the Revised Code to specify amounts to be disregarded from an 24362
individual's earned income, unearned income, or both under 24363
division (C) of section 5111.7035162.103 of the Revised Code for 24364
the purpose of determining whether the individual is within the 24365
income eligibility limit for the medicaid buy-in for workers with 24366
disabilities program.24367

       Sec. 5111.709.        Sec. 5162.109. (A) There is hereby created the 24368
medicaid buy-in advisory council. The council shall consist of 24369
all of the following:24370

       (1) The following voting members:24371

       (a) The executive director of assistive technology of Ohio or 24372
the executive director's designee;24373

       (b) The director of the axis center for public awareness of 24374
people with disabilities or the director's designee;24375

       (c) The executive director of the cerebral palsy association 24376
of Ohio or the executive director's designee;24377

       (d) The chief executive officer of Ohio advocates for mental 24378
health or the chief executive officer's designee;24379

       (e) The state director of the Ohio chapter of AARP or the 24380
state director's designee;24381

       (f) The director of the Ohio developmental disabilities 24382
council created under section 5123.35 of the Revised Code or the 24383
director's designee;24384

       (g) The executive director of the governor's council on 24385
people with disabilities created under section 3303.41 of the 24386
Revised Code or the executive director's designee;24387

       (h) The administrator of the legal rights service created 24388
under section 5123.60 of the Revised Code or the administrator's 24389
designee;24390

       (i) The chairperson of the Ohio Olmstead task force or the 24391
chairperson's designee;24392

       (j) The executive director of the Ohio statewide independent 24393
living council or the executive director's designee;24394

       (k) The president of the Ohio chapter of the national 24395
multiple sclerosis society or the president's designee;24396

       (l) The executive director of the arc of Ohio or the 24397
executive director's designee;24398

       (m) The executive director of the commission on minority 24399
health or the executive director's designee;24400

       (n) The executive director of the brain injury association of 24401
Ohio or the executive director's designee;24402

       (o) The executive officer of any other advocacy organization 24403
who volunteers to serve on the council, or such an executive 24404
officer's designee, if the other voting members, at a meeting 24405
called by the chairperson elected under division (C) of this 24406
section, determine it is appropriate for the advocacy organization 24407
to be represented on the council;24408

        (p) One or more participants who volunteer to serve on the 24409
council and are selected by the other voting members at a meeting 24410
the chairperson calls after the medicaid buy-in for workers with 24411
disabilities program is implemented.24412

       (2) The following non-voting members:24413

       (a) The director of job and family serviceshealth care 24414
administration or the director's designee;24415

       (b) The administrator of the rehabilitation services 24416
commission or the administrator's designee;24417

       (c) The director of alcohol and drug addiction services or 24418
the director's designee;24419

       (d) The director of mental retardation and developmental 24420
disabilities or the director's designee;24421

       (e) The director of mental health or the director's designee;24422

       (f) The executive officer of any other government entity, or 24423
the executive officer's designee, if the voting members, at a 24424
meeting called by the chairperson, determine it is appropriate for 24425
the government entity to be represented on the council.24426

       (B) All members of the medicaid buy-in advisory council shall 24427
serve without compensation or reimbursement, except as serving on 24428
the council is considered part of their usual job duties.24429

       (C) The voting members of the medicaid buy-in advisory 24430
council shall elect one of the members of the council to serve as 24431
the council's chairperson for a two-year term. The chairperson 24432
may be re-elected to successive terms.24433

       (D) The department of job and family serviceshealth care 24434
administration shall provide the Ohio medicaid buy-in advisory 24435
council with accommodations for the council to hold its meetings 24436
and shall provide the council with other administrative 24437
assistance the council needs to perform its duties.24438

       Sec. 5111.7010.        Sec. 5162.1010.  The director of job and family 24439
serviceshealth care administration or the director's designee 24440
shall consult with the medicaid buy-in advisory council before 24441
adopting, amending, or rescinding any rules under section 24442
5111.7085162.108 of the Revised Code governing the medicaid 24443
buy-in for workers with disabilities program.24444

        The director or designee shall meet at least quarterly with 24445
the council to discuss the program. At the meetings, the council 24446
may provide the director or designee with suggestions for 24447
improving the program and the director or designee shall provide 24448
the council with all of the following information:24449

       (A) The number of individuals who participated in the program 24450
the previous calendar quarter;24451

       (B) The cost of the program the previous calendar quarter;24452

       (C) The amount of revenue generated the previous quarter by 24453
premiums that participants pay under section 5111.7045162.104 of 24454
the Revised Code;24455

       (D) The average amount of earned income of participants' 24456
families;24457

       (E) The average amount of time participants have participated 24458
in the program;24459

       (F) The types of other health insurance participants have 24460
been able to obtain.24461

       Sec. 5111.7011.        Sec. 5162.1011.  Not less than once each year, the 24462
director of job and family serviceshealth care administration24463
shall submit a report on the medicaid buy-in for workers with 24464
disabilities program to the governor, speaker and minority leader 24465
of the house of representatives, president and minority leader of 24466
the senate, and chairpersons of the house and senate committees 24467
to which the biennial operating budget bill is referred. The 24468
report shall include all of the following information:24469

       (A) The number of individuals who participated in the 24470
medicaid buy-in for workers with disabilities program;24471

       (B) The cost of the program;24472

       (C) The amount of revenue generated by premiums that 24473
participants pay under section 5111.7045162.104 of the Revised 24474
Code;24475

       (D) The average amount of earned income of participants' 24476
families;24477

       (E) The average amount of time participants have participated 24478
in the program;24479

       (F) The types of other health insurance participants have 24480
been able to obtain.24481

       Sec. 5111.013.        Sec. 5162.15.  (A) The provision of medical 24482
assistancemedicaid to pregnant women and young children who are 24483
eligible for medical assistancemedicaid under division (A)(3)(C)24484
of section 5111.015162.01 of the Revised Code, but who are not 24485
otherwise eligible for medical assistancemedicaid under that 24486
section, shall be known as the healthy start program.24487

       (B) The department of job and family serviceshealth care 24488
administration shall do all of the following with regard to the 24489
application procedures for the healthy start program:24490

       (1) Establish a short application form for the program that 24491
requires the applicant to provide no more information than is 24492
necessary for making determinations of eligibility for the healthy 24493
start program, except that the form may require applicants to 24494
provide their social security numbers. The form shall include a24495
statement, which must be signed by the applicant, indicating that24496
she does not choose at the time of making application for the24497
program to apply for assistance provided under any other program24498
administered by the department and that she understands that she24499
is permitted at any other time to apply at the county department 24500
of job and family services of the county in which she resides for 24501
any other assistance administered by the department or department 24502
of job and family services.24503

       (2) To the extent permitted by federal law, do one or both of 24504
the following:24505

       (a) Distribute the application form for the program to each 24506
public or private entity that serves as a women, infants, and 24507
children clinic or as a child and family health clinic and to each 24508
administrative body for such clinics and train employees of each 24509
such agency or entity to provide applicants assistance in24510
completing the form;24511

       (b) In cooperation with the department of health, develop24512
arrangements under which employees of county departments of job 24513
and family services are stationed at public or private agencies or 24514
entities selected by the department of job and family services24515
health care administration that serve as women, infants, and 24516
children clinics; child and family health clinics; or 24517
administrative bodies for such clinics for the purpose both of24518
assisting applicants for the program in completing the application 24519
form and of making determinations at that location of eligibility 24520
for the program.24521

       (3) Establish performance standards by which a county 24522
department of job and family services' level of enrollment of 24523
persons potentially eligible for the program can be measured, and24524
establish acceptable levels of enrollment for each county 24525
department.24526

       (4) Direct any county department of job and family services24527
whose rate of enrollment of potentially eligible enrollees in the24528
program is below acceptable levels established under division24529
(B)(3) of this section to implement corrective action. Corrective 24530
action may include but is not limited to any one or more of the 24531
following to the extent permitted by federal law:24532

       (a) Establishing formal referral and outreach methods with24533
local health departments and local entities receiving funding24534
through the bureau of maternal and child health;24535

       (b) Designating a specialized intake unit within the county 24536
department for healthy start applicants;24537

       (c) Establishing abbreviated timeliness requirements to24538
shorten the time between receipt of an application and the24539
scheduling of an initial application interview;24540

       (d) Establishing a system for telephone scheduling of intake 24541
interviews for applicants;24542

       (e) Establishing procedures to minimize the time an applicant 24543
must spend in completing the application and eligibility 24544
determination process, including permitting applicants to complete 24545
the process at times other than the regular business hours of the 24546
county department and at locations other than the offices of the 24547
county department.24548

       (C) To the extent permitted by federal law, local funds,24549
whether from public or private sources, expended by a county24550
department for administration of the healthy start program shall 24551
be considered to have been expended by the state for the purpose 24552
of determining the extent to which the state has complied with any 24553
federal requirement that the state provide funds to match federal 24554
funds for medical assistancemedicaid, except that this division 24555
shall not affect the amount of funds the county is entitled to24556
receive under section 5101.16, 5101.161,5160.26 or 5111.01224557
5160.261 of the Revised Code.24558

       (D) The director of job and family serviceshealth care 24559
administration shall do one or both of the following:24560

       (1) To the extent that federal funds are provided for such24561
assistance, adopt a plan for granting presumptive eligibility for24562
pregnant women applying for healthy start;24563

       (2) To the extent permitted by federal medicaid regulations, 24564
adopt a plan for making same-day determinations of eligibility for 24565
pregnant women applying for healthy start.24566

       (E) A county department of job and family services that 24567
maintains offices at more than one location shall accept 24568
applications for the healthy start program at all of those 24569
locations.24570

       (F) The director of job and family serviceshealth care 24571
administration shall adopt rules in accordance with section 111.15 24572
of the Revised Code as necessary to implement this section.24573

       Sec. 5111.016.        Sec. 5162.16. (A) As used in this section, 24574
"healthcheck" has the same meaning as in section 3313.714 of the 24575
Revised Code.24576

       (B) The department of job and family serviceshealth care 24577
administration shall adopt rules in accordance with Chapter 119. 24578
of the Revised Code establishing a combination of written and 24579
oral methods designed to provide information about healthcheck 24580
to all persons eligible for the program or their parents or 24581
guardians. The department shall ensure that its methods of 24582
providing information are effective. The methods shall comply 24583
with federal law and regulations.24584

       Each county department of job and family services or other24585
entity that distributes or accepts applications for medical 24586
assistancemedicaid shall prominently display a notice that 24587
complies with the rules adopted under this division.24588

       Sec. 5162.17. The department of health care administration 24589
shall establish a disability determination unit and develop 24590
guidelines for expediting reviews of applications for the medicaid 24591
program for persons who have been referred to the unit under 24592
division (D) of section 329.043 of the Revised Code. The 24593
department shall make determinations of eligibility for medicaid 24594
for any such person within the time prescribed by federal 24595
regulations.24596

       Sec. 5111.0119.        Sec. 5162.18.  (A)(1) As used in this section, 24597
subject to division (A)(2) of this section, "state or local 24598
correctional facility" means any of the following:24599

       (a) A "state correctional institution," as defined in section 24600
2967.01 of the Revised Code;24601

       (b) A "local correctional facility," as defined in section 24602
2903.13 of the Revised Code;24603

       (c) A correctional facility that is privately operated and 24604
managed pursuant to section 9.06 of the Revised Code.24605

       (2) "State or local correctional facility" does not include 24606
any facility operated directly by or at the direction of the 24607
department of youth services.24608

       (B) If a person who is confined in a state or local 24609
correctional facility was a medicaid recipient immediately prior 24610
to being confined in the facility, all of the following apply:24611

       (1) The person's eligibility for medicaid while so confined 24612
shall be suspended due to the confinement.24613

       (2) No medicaid payment shall be made for any care, 24614
services, or supplies provided to the person during the 24615
suspension described in division (B)(1) of this section. 24616

       (3) The suspension described in division (B)(1) of this 24617
section shall end upon the release of the person from the 24618
confinement.24619

       (4) Except as provided in division (C) of this section, the 24620
person shall not be required to reapply or undergo a 24621
redetermination of eligibility for medicaid when the suspension 24622
described in division (B)(1) of this section ends. 24623

       (C) A person may be disenrolled from medicaid any time after 24624
the suspension described in division (B)(1) of this section ends 24625
if the person is no longer eligible for medicaid. A person may be 24626
required to undergo a redetermination of eligibility for medicaid 24627
any time after the suspension described in division (B)(1) of this 24628
section ends if it is time or past time for the person's 24629
eligibility redetermination or the person's circumstances have 24630
changed in a manner warranting a redetermination.24631

       (D) The department of job and family serviceshealth care 24632
administration shall take the steps necessary to begin 24633
implementation of this section not later than September 1, 2009.24634

       Sec. 5111.011.        Sec. 5162.20. (A) The director of job and family 24635
serviceshealth care administration shall adopt rules establishing 24636
eligibility requirements for the medicaid program. The rules shall 24637
be adopted pursuant to section 111.15 of the Revised Code and 24638
shall be consistent with federal and state law. The rules shall 24639
include rules that do all of the following:24640

       (1) Establish requirements to be followed in applying for 24641
medicaid, making determinations of eligibility for medicaid, and 24642
verifying eligibility for medicaid;24643

       (2) Establish standards consistent with federal law for 24644
allocating income and resources as income and resources of the 24645
spouse, children, parents, or stepparents of a recipient of or 24646
applicant for medicaid;24647

       (2)(3) Define the term "resources" as used in division 24648
(A)(1)(2) of this section;24649

       (3)(4) Specify the number of months that is to be used for 24650
the purpose of the term "look-back date" used in section 5111.011624651
5162.21 of the Revised Code;24652

       (4)(5) Establish processes to be used to determine both of 24653
the following:24654

       (a) The date an institutionalized individual's ineligibility 24655
for services under section 5111.01165162.21 of the Revised Code 24656
is to begin;24657

       (b) The number of months an institutionalized individual's 24658
ineligibility for such services is to continue.24659

       (5)(6) Establish exceptions to the period of ineligibility 24660
that an institutionalized individual would otherwise be subject to 24661
under section 5111.01165162.21 of the Revised Code;24662

       (6)(7) Define the term "other medicaid-funded long-term care 24663
services" as used in sections 5111.01175162.22 and 5111.011824664
5162.23 of the Revised Code;24665

       (7)(8) For the purpose of division (C)(2)(c) of section 24666
5111.01175162.22 of the Revised Code, establish the process to 24667
determine whether the child of an aged, blind, or disabled 24668
individual is financially dependent on the individual for housing.24669

       (B) Notwithstanding any provision of state law, including 24670
statutes, administrative rules, common law, and court rules, 24671
regarding real or personal property or domestic relations, the 24672
standards established under rules adopted under division (A)(1)(2)24673
of this section shall be used to determine eligibility for 24674
medicaid.24675

       Sec. 5111.0116.        Sec. 5162.21.  (A) As used in this section:24676

       (1) "Assets" include all of an individual's income and 24677
resources and those of the individual's spouse, including any 24678
income or resources the individual or spouse is entitled to but 24679
does not receive because of action by any of the following:24680

       (a) The individual or spouse;24681

       (b) A person or government entity, including a court or 24682
administrative agency, with legal authority to act in place of or 24683
on behalf of the individual or spouse;24684

       (c) A person or government entity, including a court or 24685
administrative agency, acting at the direction or on the request 24686
of the individual or spouse.24687

       (2) "Home and community-based services" means home and 24688
community-based services furnished under a medicaid waiver granted 24689
by the United States secretary of health and human services under 24690
42 U.S.C. 1396n(c) or (d).24691

       (3) "Institutionalized individual" means a resident of a 24692
nursing facility, an inpatient in a medical institution for whom a 24693
payment is made based on a level of care provided in a nursing 24694
facility, or an individual described in 42 U.S.C. 24695
1396a(a)(10)(A)(ii)(VI).24696

       (4) "Look-back date" means the date that is a number of 24697
months specified in rules adopted under section 5111.0115162.2024698
of the Revised Code immediately before either of the following:24699

       (a) The date an individual becomes an institutionalized 24700
individual if the individual is eligible for medicaid on that 24701
date;24702

       (b) The date an individual applies for medicaid while an 24703
institutionalized individual.24704

       (5) "Nursing facility" has the same meaning as in section 24705
5111.205164.01 of the Revised Code.24706

       (6) "Nursing facility equivalent services" means services 24707
that are covered by the medicaid program, equivalent to nursing 24708
facility services, provided by an institution that provides the 24709
same level of care as a nursing facility, and provided to an 24710
inpatient of the institution who is a medicaid recipient eligible 24711
for medicaid-covered nursing facility equivalent services.24712

       (7) "Nursing facility services" means nursing facility 24713
services covered by the medicaid program that a nursing facility 24714
provides to a resident of the nursing facility who is a medicaid 24715
recipient eligible for medicaid-covered nursing facility services.24716

       (B) Except as provided in rules adopted under section 24717
5111.0115162.20 of the Revised Code, an institutionalized 24718
individual is ineligible for nursing facility services, nursing 24719
facility equivalent services, and home and community-based 24720
services if the individual or individual's spouse disposes of 24721
assets for less than fair market value on or after the look-back 24722
date. The institutionalized individual's ineligibility shall begin 24723
on a date determined in accordance with rules adopted under 24724
section 5111.0115162.20 of the Revised Code and shall continue 24725
for a number of months determined in accordance with such rules.24726

       (C) To secure compliance with this section, the director of 24727
job and family serviceshealth care administration may require an 24728
individual, as a condition of initial or continued eligibility for 24729
medicaid, to provide documentation of the individual's assets up 24730
to five years before the date the individual becomes an 24731
institutionalized individual if the individual is eligible for 24732
medicaid on that date or the date the individual applies for 24733
medicaid while an institutionalized individual. Documentation may 24734
include tax returns, records from financial institutions, and real 24735
property records.24736

       Sec. 5111.0117.        Sec. 5162.22.  (A) As used in this section and 24737
section 5111.01185162.23 of the Revised Code:24738

       (1) "ICF/MR services" means intermediate care facility for 24739
the mentally retarded services covered by the medicaid program 24740
that an intermediate care facility for the mentally retarded 24741
provides to a resident of the facility who is a medicaid recipient 24742
eligible for medicaid-covered intermediate care facility for the 24743
mentally retarded services.24744

       (2) "Intermediate care facility for the mentally retarded" 24745
has the same meaning as in section 5111.205164.01 of the Revised 24746
Code.24747

       (3) "Nursing facility" has the same meaning as in section 24748
5111.205164.01 of the Revised Code.24749

       (4) "Nursing facility services" means nursing facility 24750
services covered by the medicaid program that a nursing facility 24751
provides to a resident of the nursing facility who is a medicaid 24752
recipient eligible for medicaid-covered nursing facility services.24753

       (5) "Other medicaid-funded long-term care services" has the 24754
meaning specified in rules adopted under section 5111.0115162.2024755
of the Revised Code.24756

       (B) Except as provided by division (C) of this section and 24757
for the purpose of determining whether an aged, blind, or disabled 24758
individual is eligible for nursing facility services, ICF/MR 24759
services, or other medicaid-funded long-term care services, the 24760
director of job and family serviceshealth care administration may 24761
consider an aged, blind, or disabled individual's real property to 24762
not be the individual's homestead or principal place of residence 24763
once the individual has resided in a nursing facility, 24764
intermediate care facility for the mentally retarded, or other 24765
medical institution for at least thirteen months.24766

       (C) Division (B) of this section does not apply to an 24767
individual if any of the following reside in the individual's real 24768
property that, because of this division, continues to be 24769
considered the individual's homestead or principal place of 24770
residence:24771

       (1) The individual's spouse;24772

       (2) The individual's child if any of the following apply:24773

       (a) The child is under twenty-one years of age.24774

       (b) The child is considered blind or disabled under 42 U.S.C. 24775
1382c.24776

       (c) The child is financially dependent on the individual for 24777
housing as determined in accordance with rules adopted under 24778
section 5111.0115162.20 of the Revised Code.24779

       (3) The individual's sibling if the sibling has a verified 24780
equity interest in the real property and resided in the real 24781
property for at least one year immediately before the date the 24782
individual was admitted to the nursing facility, intermediate care 24783
facility for the mentally retarded, or other medical institution.24784

       Sec. 5111.0118.        Sec. 5162.23.  (A) Except as otherwise provided by 24785
this section, no individual shall qualify for nursing facility 24786
services or other medicaid-funded long-term care services if the 24787
individual's equity interest in the individual's home exceeds five 24788
hundred thousand dollars. The director of job and family services24789
health care administration shall increase this amount effective 24790
January 1, 2011, and the first day of each year thereafter, by the 24791
percentage increase in the consumer price index for all urban 24792
consumers (all items; United States city average), rounded to the 24793
nearest one thousand dollars.24794

       (B) This section does not apply to an individual if either of 24795
the following applies:24796

       (1) Either of the following lawfully reside in the 24797
individual's home:24798

       (a) The individual's spouse;24799

       (b) The individual's child if the child is under twenty-one 24800
years of age or, under 42 U.S.C. 1382c, considered blind or 24801
disabled.24802

       (2) The individual qualifies, pursuant to the process 24803
established under division (C) of this section, for a waiver of 24804
this section due to a demonstrated hardship.24805

       (C) The director shall establish a process by which 24806
individuals may obtain a waiver of this section due to a 24807
demonstrated hardship. The process shall be consistent with the 24808
process for such waivers established by the United States 24809
secretary of health and human services under 42 U.S.C. 24810
1396p(f)(4).24811

       (D) Nothing in this section shall be construed as preventing 24812
an individual from using a reverse mortgage or home equity loan to 24813
reduce the individual's total equity interest in the home.24814

       Sec. 5111.015.        Sec. 5162.24.  (A) If the United States secretary of24815
health and human services grants a waiver of any contrary federal24816
requirements governing the medical assistancemedicaid program or 24817
the director of job and family serviceshealth care administration24818
determines that there are no contrary federal requirements, 24819
divisions (A)(1) and (2) of this section apply to determinations 24820
of eligibility under this chapter:24821

       (1) In determining the eligibility of an assistance group for 24822
assistance under this chapter, the department of job and family 24823
serviceshealth care administration shall exclude from the income 24824
and resources applicable to the assistance group the value of any 24825
tuition payment contract entered into under section 3334.09 of the 24826
Revised Code or any scholarship awarded under section 3334.18 of 24827
the Revised Code and the amount of payments made by the Ohio 24828
tuition trust authority under section 3334.09 of the Revised Code 24829
pursuant to the contract or scholarship.24830

       (2) The department shall not require any person to terminate 24831
a tuition payment contract entered into under Chapter 3334. of the 24832
Revised Code as a condition of an assistance group's eligibility 24833
for assistance under this chaptermedicaid.24834

       (B) To the extent required by federal law, the department24835
shall include as income any refund paid under section 3334.10 of24836
the Revised Code to a member of the assistance group.24837

       (C) Not later than sixty days after July 1, 1994, the 24838
department shall apply to the United States department of health 24839
and human services for a waiver of any federal requirements that 24840
otherwise would be violated by implementation of division (A) of 24841
this section.24842

       Sec. 5111.15.        Sec. 5162.25.  If a medicaid recipient of medical 24843
assistance is the beneficiary of a trust created pursuant to 24844
section 5815.28 of the Revised Code, then, notwithstanding any 24845
contrary provision of this chapter or of a rule adopted pursuant 24846
to this chapter, divisions (C) and (D) of that section shall apply 24847
in determining the assets or resources of the recipient, the24848
recipient's estate, the settlor, or the settlor's estate and to 24849
claims arising under this chapter against the recipient, the 24850
recipient's estate, the settlor, or the settlor's estate.24851

       Sec. 5111.151.        Sec. 5162.26. (A) This section applies to 24852
eligibility determinations for all cases involving medicaid24853
medical assistance provided pursuant to this chapterunder the 24854
medicaid program, qualified medicare beneficiaries, specified 24855
low-income medicare beneficiaries, qualifying individuals-1, 24856
qualifying individuals-2, and medical assistancemedicaid for 24857
covered families and children.24858

        (B) As used in this section:24859

        (1) "Trust" means any arrangement in which a grantor 24860
transfers real or personal property to a trust with the intention 24861
that it be held, managed, or administered by at least one trustee 24862
for the benefit of the grantor or beneficiaries. "Trust" includes 24863
any legal instrument or device similar to a trust.24864

        (2) "Legal instrument or device similar to a trust" includes, 24865
but is not limited to, escrow accounts, investment accounts, 24866
partnerships, contracts, and other similar arrangements that are 24867
not called trusts under state law but are similar to a trust and 24868
to which all of the following apply:24869

        (a) The property in the trust is held, managed, retained, or 24870
administered by a trustee.24871

        (b) The trustee has an equitable, legal, or fiduciary duty to 24872
hold, manage, retain, or administer the property for the benefit 24873
of the beneficiary.24874

        (c) The trustee holds identifiable property for the 24875
beneficiary.24876

        (3) "Grantor" is a person who creates a trust, including all 24877
of the following:24878

        (a) An individual;24879

        (b) An individual's spouse;24880

        (c) A person, including a court or administrative body, with 24881
legal authority to act in place of or on behalf of an individual 24882
or an individual's spouse;24883

        (d) A person, including a court or administrative body, that 24884
acts at the direction or on request of an individual or the 24885
individual's spouse.24886

        (4) "Beneficiary" is a person or persons, including a 24887
grantor, who benefits in some way from a trust.24888

        (5) "Trustee" is a person who manages a trust's principal and 24889
income for the benefit of the beneficiaries.24890

        (6) "Person" has the same meaning as in section 1.59 of the 24891
Revised Code and includes an individual, corporation, business 24892
trust, estate, trust, partnership, and association.24893

        (7) "Applicant" is an individual who applies for medicaid or 24894
the individual's spouse.24895

        (8) "Recipient" is an individual who receives medicaid or the 24896
individual's spouse.24897

        (9) "Revocable trust" is a trust that can be revoked by the 24898
grantor or the beneficiary, including all of the following, even 24899
if the terms of the trust state that it is irrevocable:24900

        (a) A trust that provides that the trust can be terminated 24901
only by a court;24902

        (b) A trust that terminates on the happening of an event, but 24903
only if the event occurs at the direction or control of the 24904
grantor, beneficiary, or trustee.24905

        (10) "Irrevocable trust" is a trust that cannot be revoked by 24906
the grantor or terminated by a court and that terminates only on 24907
the occurrence of an event outside of the control or direction of 24908
the beneficiary or grantor.24909

        (11) "Payment" is any disbursal from the principal or income 24910
of the trust, including actual cash, noncash or property 24911
disbursements, or the right to use and occupy real property.24912

        (12) "Payments to or for the benefit of the applicant or 24913
recipient" is a payment to any person resulting in a direct or 24914
indirect benefit to the applicant or recipient.24915

        (13) "Testamentary trust" is a trust that is established by a 24916
will and does not take effect until after the death of the person 24917
who created the trust.24918

        (C) If an applicant or recipient is a beneficiary of a trust, 24919
the county department of job and family services shall determine 24920
what type of trust it is and shall treat the trust in accordance 24921
with the appropriate provisions of this section and rules adopted 24922
by the department of job and family serviceshealth care 24923
administration governing trusts. The county department of job and 24924
family services may determine that the trust or portion of the 24925
trust is one of the following:24926

        (1) A countable resource;24927

        (2) Countable income;24928

        (3) A countable resource and countable income;24929

        (4) Not a countable resource or countable income.24930

        (D)(1) A trust or legal instrument or device similar to a 24931
trust shall be considered a medicaid qualifying trust if all of 24932
the following apply:24933

       (a) The trust was established on or prior to August 10, 1993.24934

       (b) The trust was not established by a will.24935

       (c) The trust was established by an applicant or recipient.24936

       (d) The applicant or recipient is or may become the 24937
beneficiary of all or part of the trust.24938

       (e) Payment from the trust is determined by one or more 24939
trustees who are permitted to exercise any discretion with respect 24940
to the distribution to the applicant or recipient.24941

       (2) If a trust meets the requirement of division (D)(1) of 24942
this section, the amount of the trust that is considered by the 24943
county department of job and family services as an available 24944
resource to the applicant or recipient shall be the maximum amount 24945
of payments permitted under the terms of the trust to be 24946
distributed to the applicant or recipient, assuming the full 24947
exercise of discretion by the trustee or trustees. The maximum 24948
amount shall include only amounts that are permitted to be 24949
distributed but are not distributed from either the income or 24950
principal of the trust.24951

       (3) Amounts that are actually distributed from a medicaid 24952
qualifying trust to a beneficiary for any purpose shall be treated 24953
in accordance with rules adopted by the department of job and 24954
family serviceshealth care administration governing income.24955

       (4) Availability of a medicaid qualifying trust shall be 24956
considered without regard to any of the following:24957

       (a) Whether or not the trust is irrevocable or was 24958
established for purposes other than to enable a grantor to qualify 24959
for medicaid, medical assistancemedicaid for covered families and 24960
children, or as a qualified medicare beneficiary, specified 24961
low-income medicare beneficiary, qualifying individual-1, or 24962
qualifying individual-2;24963

       (b) Whether or not the trustee actually exercises discretion.24964

       (5) If any real or personal property is transferred to a 24965
medicaid qualifying trust that is not distributable to the 24966
applicant or recipient, the transfer shall be considered an 24967
improper disposition of assets and shall be subject to section 24968
5111.01165162.21 of the Revised Code and rules to implement that 24969
section adopted under section 5111.0115162.20 of the Revised 24970
Code.24971

       (6) The baseline date for the look-back period for 24972
disposition of assets involving a medicaid qualifying trust shall 24973
be the date on which the applicant or recipient is both 24974
institutionalized and first applies for medicaid.24975

       (E)(1) A trust or legal instrument or device similar to a 24976
trust shall be considered a self-settled trust if all of the 24977
following apply:24978

        (a) The trust was established on or after August 11, 1993.24979

        (b) The trust was not established by a will.24980

        (c) The trust was established by an applicant or recipient, 24981
spouse of an applicant or recipient, or a person, including a 24982
court or administrative body, with legal authority to act in place 24983
of or on behalf of an applicant, recipient, or spouse, or acting 24984
at the direction or on request of an applicant, recipient, or 24985
spouse.24986

        (2) A trust that meets the requirements of division (E)(1) of 24987
this section and is a revocable trust shall be treated by the 24988
county department of job and family services as follows:24989

        (a) The corpus of the trust shall be considered a resource 24990
available to the applicant or recipient.24991

        (b) Payments from the trust to or for the benefit of the 24992
applicant or recipient shall be considered unearned income of the 24993
applicant or recipient.24994

        (c) Any other payments from the trust shall be considered an 24995
improper disposition of assets and shall be subject to section 24996
5111.01165162.21 of the Revised Code and rules to implement that 24997
section adopted under section 5111.0115162.20 of the Revised 24998
Code.24999

        (3) A trust that meets the requirements of division (E)(1) of 25000
this section and is an irrevocable trust shall be treated by the 25001
county department of job and family services as follows:25002

        (a) If there are any circumstances under which payment from 25003
the trust could be made to or for the benefit of the applicant or 25004
recipient, including a payment that can be made only in the 25005
future, the portion from which payments could be made shall be 25006
considered a resource available to the applicant or recipient. The 25007
county department of job and family services shall not take into 25008
account when payments can be made.25009

        (b) Any payment that is actually made to or for the benefit 25010
of the applicant or recipient from either the corpus or income 25011
shall be considered unearned income.25012

        (c) If a payment is made to someone other than to the 25013
applicant or recipient and the payment is not for the benefit of 25014
the applicant or recipient, the payment shall be considered an 25015
improper disposition of assets and shall be subject to section 25016
5111.01165162.21 of the Revised Code and rules to implement that 25017
section adopted under section 5111.0115162.20 of the Revised 25018
Code.25019

        (d) The date of the disposition shall be the later of the 25020
date of establishment of the trust or the date of the occurrence 25021
of the event.25022

        (e) When determining the value of the disposed asset under 25023
this provision, the value of the trust shall be its value on the 25024
date payment to the applicant or recipient was foreclosed.25025

        (f) Any income earned or other resources added subsequent to 25026
the foreclosure date shall be added to the total value of the 25027
trust.25028

        (g) Any payments to or for the benefit of the applicant or 25029
recipient after the foreclosure date but prior to the application 25030
date shall be subtracted from the total value. Any other payments 25031
shall not be subtracted from the value.25032

        (h) Any addition of assets after the foreclosure date shall 25033
be considered a separate disposition.25034

        (4) If a trust is funded with assets of another person or 25035
persons in addition to assets of the applicant or recipient, the 25036
applicable provisions of this section and rules adopted by the 25037
department of job and family serviceshealth care administration25038
governing trusts shall apply only to the portion of the trust 25039
attributable to the applicant or recipient.25040

        (5) The availability of a self-settled trust shall be 25041
considered without regard to any of the following:25042

        (a) The purpose for which the trust is established;25043

        (b) Whether the trustees have exercised or may exercise 25044
discretion under the trust;25045

        (c) Any restrictions on when or whether distributions may be 25046
made from the trust;25047

        (d) Any restrictions on the use of distributions from the 25048
trust.25049

        (6) The baseline date for the look-back period for 25050
dispositions of assets involving a self-settled trust shall be the 25051
date on which the applicant or recipient is both institutionalized 25052
and first applies for medicaid.25053

        (F) The principal or income from any of the following shall 25054
be exempt from being counted as a resource by a county department 25055
of job and family services:25056

        (1)(a) A special needs trust that meets all of the following 25057
requirements:25058

        (i) The trust contains assets of an applicant or recipient 25059
under sixty-five years of age and may contain the assets of other 25060
individuals.25061

        (ii) The applicant or recipient is disabled as defined in 25062
rules adopted by the department of job and family serviceshealth 25063
care administration.25064

        (iii) The trust is established for the benefit of the 25065
applicant or recipient by a parent, grandparent, legal guardian, 25066
or a court.25067

        (iv) The trust requires that on the death of the applicant or 25068
recipient the state will receive all amounts remaining in the 25069
trust up to an amount equal to the total amount of medicaid paid 25070
on behalf of the applicant or recipient.25071

        (b) If a special needs trust meets the requirements of 25072
division (F)(1)(a) of this section and has been established for a 25073
disabled applicant or recipient under sixty-five years of age, the 25074
exemption for the trust granted pursuant to division (F) of this 25075
section shall continue after the disabled applicant or recipient 25076
becomes sixty-five years of age if the applicant or recipient 25077
continues to be disabled as defined in rules adopted by the 25078
department of job and family serviceshealth care administration. 25079
Except for income earned by the trust, the grantor shall not add 25080
to or otherwise augment the trust after the applicant or recipient 25081
attains sixty-five years of age. An addition or augmentation of 25082
the trust by the applicant or recipient with the applicant's own 25083
assets after the applicant or recipient attains sixty-five years 25084
of age shall be treated as an improper disposition of assets.25085

        (c) Cash distributions to the applicant or recipient shall be 25086
counted as unearned income. All other distributions from the trust 25087
shall be treated as provided in rules adopted by the department of 25088
job and family serviceshealth care administration governing 25089
in-kind income.25090

        (d) Transfers of assets to a special needs trust shall not be 25091
treated as an improper transfer of resources. Assets held prior to 25092
the transfer to the trust shall be considered as countable assets 25093
or countable income or countable assets and income.25094

        (2)(a) A qualifying income trust that meets all of the 25095
following requirements:25096

        (i) The trust is composed only of pension, social security, 25097
and other income to the applicant or recipient, including 25098
accumulated interest in the trust.25099

        (ii) The income is received by the individual and the right 25100
to receive the income is not assigned or transferred to the trust.25101

        (iii) The trust requires that on the death of the applicant 25102
or recipient the state will receive all amounts remaining in the 25103
trust up to an amount equal to the total amount of medicaid paid 25104
on behalf of the applicant or recipient.25105

        (b) No resources shall be used to establish or augment the 25106
trust.25107

        (c) If an applicant or recipient has irrevocably transferred 25108
or assigned the applicant's or recipient's right to receive income 25109
to the trust, the trust shall not be considered a qualifying 25110
income trust by the county department of job and family services.25111

        (d) Income placed in a qualifying income trust shall not be 25112
counted in determining an applicant's or recipient's eligibility 25113
for medicaid. The recipient of the funds may place any income 25114
directly into a qualifying income trust without those funds 25115
adversely affecting the applicant's or recipient's eligibility for 25116
medicaid. Income generated by the trust that remains in the trust 25117
shall not be considered as income to the applicant or recipient.25118

        (e) All income placed in a qualifying income trust shall be 25119
combined with any countable income not placed in the trust to 25120
arrive at a base income figure to be used for spend down 25121
calculations.25122

        (f) The base income figure shall be used for post-eligibility 25123
deductions, including personal needs allowance, monthly income 25124
allowance, family allowance, and medical expenses not subject to 25125
third party payment. Any income remaining shall be used toward 25126
payment of patient liability. Payments made from a qualifying 25127
income trust shall not be combined with the base income figure for 25128
post-eligibility calculations.25129

        (g) The base income figure shall be used when determining the 25130
spend down budget for the applicant or recipient. Any income 25131
remaining after allowable deductions are permitted as provided 25132
under rules adopted by the department of job and family services25133
health care administration shall be considered the applicant's or 25134
recipient's spend down liability.25135

        (3)(a) A pooled trust that meets all of the following 25136
requirements:25137

        (i) The trust contains the assets of the applicant or 25138
recipient of any age who is disabled as defined in rules adopted 25139
by the department of job and family serviceshealth care 25140
administration.25141

        (ii) The trust is established and managed by a nonprofit 25142
association.25143

        (iii) A separate account is maintained for each beneficiary 25144
of the trust but, for purposes of investment and management of 25145
funds, the trust pools the funds in these accounts.25146

        (iv) Accounts in the trust are established by the applicant 25147
or recipient, the applicant's or recipient's parent, grandparent, 25148
or legal guardian, or a court solely for the benefit of 25149
individuals who are disabled.25150

        (v) The trust requires that, to the extent that any amounts 25151
remaining in the beneficiary's account on the death of the 25152
beneficiary are not retained by the trust, the trust pay to the 25153
state the amounts remaining in the trust up to an amount equal to 25154
the total amount of medicaid paid on behalf of the beneficiary.25155

        (b) Cash distributions to the applicant or recipient shall be 25156
counted as unearned income. All other distributions from the trust 25157
shall be treated as provided in rules adopted by the department of 25158
job and family serviceshealth care administration governing 25159
in-kind income.25160

        (c) Transfers of assets to a pooled trust shall not be 25161
treated as an improper disposition of assets. Assets held prior to 25162
the transfer to the trust shall be considered as countable assets, 25163
countable income, or countable assets and income.25164

        (4) A supplemental services trust that meets the requirements 25165
of section 5815.28 of the Revised Code and to which all of the 25166
following apply:25167

        (a) A person may establish a supplemental services trust 25168
pursuant to section 5815.28 of the Revised Code only for another 25169
person who is eligible to receive services through one of the 25170
following agencies:25171

        (i) The department of mental retardation and developmental 25172
disabilities;25173

        (ii) A county board of mental retardation and developmental 25174
disabilities;25175

        (iii) The department of mental health;25176

        (iv) A board of alcohol, drug addiction, and mental health 25177
services.25178

        (b) A county department of job and family services shall not 25179
determine eligibility for another agency's program. An applicant 25180
or recipient shall do one of the following:25181

        (i) Provide documentation from one of the agencies listed in 25182
division (F)(4)(a) of this section that establishes that the 25183
applicant or recipient was determined to be eligible for services 25184
from the agency at the time of the creation of the trust;25185

        (ii) Provide an order from a court of competent jurisdiction 25186
that states that the applicant or recipient was eligible for 25187
services from one of the agencies listed in division (F)(4)(a) of 25188
this section at the time of the creation of the trust.25189

        (c) At the time the trust is created, the trust principal 25190
does not exceed the maximum amount permitted. The maximum amount 25191
permitted in calendar year 2006 is two hundred twenty-two thousand 25192
dollars. Each year thereafter, the maximum amount permitted is the 25193
prior year's amount plus two thousand dollars.25194

        (d) A county department of job and family services shall 25195
review the trust to determine whether it complies with the 25196
provisions of section 5815.28 of the Revised Code.25197

        (e) Payments from supplemental services trusts shall be 25198
exempt as long as the payments are for supplemental services as 25199
defined in rules adopted by the department of job and family 25200
serviceshealth care administration. All supplemental services 25201
shall be purchased by the trustee and shall not be purchased 25202
through direct cash payments to the beneficiary.25203

        (f) If a trust is represented as a supplemental services 25204
trust and a county department of job and family services 25205
determines that the trust does not meet the requirements provided 25206
in division (F)(4) of this section and section 5815.28 of the 25207
Revised Code, the county department of job and family services 25208
shall not consider it an exempt trust.25209

        (G)(1) A trust or legal instrument or device similar to a 25210
trust shall be considered a trust established by an individual for 25211
the benefit of the applicant or recipient if all of the following 25212
apply:25213

        (a) The trust is created by a person other than the applicant 25214
or recipient.25215

        (b) The trust names the applicant or recipient as a 25216
beneficiary.25217

        (c) The trust is funded with assets or property in which the 25218
applicant or recipient has never held an ownership interest prior 25219
to the establishment of the trust.25220

        (2) Any portion of a trust that meets the requirements of 25221
division (G)(1) of this section shall be an available resource 25222
only if the trust permits the trustee to expend principal, corpus, 25223
or assets of the trust for the applicant's or recipient's medical 25224
care, care, comfort, maintenance, health, welfare, general well 25225
being, or any combination of these purposes.25226

        (3) A trust that meets the requirements of division (G)(1) of 25227
this section shall be considered an available resource even if the 25228
trust contains any of the following types of provisions:25229

        (a) A provision that prohibits the trustee from making 25230
payments that would supplant or replace medicaid or other public 25231
assistance;25232

        (b) A provision that prohibits the trustee from making 25233
payments that would impact or have an effect on the applicant's or 25234
recipient's right, ability, or opportunity to receive medicaid or 25235
other public assistance;25236

        (c) A provision that attempts to prevent the trust or its 25237
corpus or principal from being counted as an available resource.25238

        (4) A trust that meets the requirements of division (G)(1) of 25239
this section shall not be counted as an available resource if at 25240
least one of the following circumstances applies:25241

        (a) If a trust contains a clear statement requiring the 25242
trustee to preserve a portion of the trust for another beneficiary 25243
or remainderman, that portion of the trust shall not be counted as 25244
an available resource. Terms of a trust that grant discretion to 25245
preserve a portion of the trust shall not qualify as a clear 25246
statement requiring the trustee to preserve a portion of the 25247
trust.25248

        (b) If a trust contains a clear statement requiring the 25249
trustee to use a portion of the trust for a purpose other than 25250
medical care, care, comfort, maintenance, welfare, or general well 25251
being of the applicant or recipient, that portion of the trust 25252
shall not be counted as an available resource. Terms of a trust 25253
that grant discretion to limit the use of a portion of the trust 25254
shall not qualify as a clear statement requiring the trustee to 25255
use a portion of the trust for a particular purpose.25256

        (c) If a trust contains a clear statement limiting the 25257
trustee to making fixed periodic payments, the trust shall not be 25258
counted as an available resource and payments shall be treated in 25259
accordance with rules adopted by the department of job and family 25260
serviceshealth care administration governing income. Terms of a 25261
trust that grant discretion to limit payments shall not qualify as 25262
a clear statement requiring the trustee to make fixed periodic 25263
payments.25264

        (d) If a trust contains a clear statement that requires the 25265
trustee to terminate the trust if it is counted as an available 25266
resource, the trust shall not be counted as an available resource. 25267
Terms of a trust that grant discretion to terminate the trust do 25268
not qualify as a clear statement requiring the trustee to 25269
terminate the trust.25270

        (e) If a person obtains a judgment from a court of competent 25271
jurisdiction that expressly prevents the trustee from using part 25272
or all of the trust for the medical care, care, comfort, 25273
maintenance, welfare, or general well being of the applicant or 25274
recipient, the trust or that portion of the trust subject to the 25275
court order shall not be counted as a resource.25276

        (f) If a trust is specifically exempt from being counted as 25277
an available resource by a provision of the Revised Code, rules, 25278
or federal law, the trust shall not be counted as a resource.25279

        (g) If an applicant or recipient presents a final judgment 25280
from a court demonstrating that the applicant or recipient was 25281
unsuccessful in a civil action against the trustee to compel 25282
payments from the trust, the trust shall not be counted as an 25283
available resource.25284

        (h) If an applicant or recipient presents a final judgment 25285
from a court demonstrating that in a civil action against the 25286
trustee the applicant or recipient was only able to compel limited 25287
or periodic payments, the trust shall not be counted as an 25288
available resource and payments shall be treated in accordance 25289
with rules adopted by the department of job and family services25290
health care administration governing income.25291

        (i) If an applicant or recipient provides written 25292
documentation showing that the cost of a civil action brought to 25293
compel payments from the trust would be cost prohibitive, the 25294
trust shall not be counted as an available resource.25295

        (5) Any actual payments to the applicant or recipient from a 25296
trust that meet the requirements of division (G)(1) of this 25297
section, including trusts that are not counted as an available 25298
resource, shall be treated as provided in rules adopted by the 25299
department of job and family serviceshealth care administration25300
governing income. Payments to any person other than the applicant 25301
or recipient shall not be considered income to the applicant or 25302
recipient. Payments from the trust to a person other than the 25303
applicant or recipient shall not be considered an improper 25304
disposition of assets.25305

       Sec. 5111.181.        Sec. 5162.30.  (A) The general assembly hereby finds 25306
that the state has an insurable interest in medical assistance25307
medicaid recipients because of the state's statutory right to 25308
recover from the estate of a recipient state funds used to provide 25309
the recipient with medical care and services.25310

       (B) As used in this section:25311

       (1) "Beneficiary" means the person or entity designated in a 25312
life insurance policy to receive the proceeds of the policy on the 25313
death of the insured or maturity of the policy.25314

       (2) "Owner" means the person who has the right to designate 25315
the beneficiary of a life insurance policy and to change the 25316
designation.25317

       (C) Notwithstanding section 5111.0115162.20 of the Revised 25318
Code, the value of a life insurance policy that would otherwise be25319
considered a resource in determining eligibility for the medical25320
assistancemedicaid program shall be excluded from any 25321
determination of a person's eligibility for the medical assistance25322
medicaid program if the owner designates the department of job and 25323
family serviceshealth care administration as beneficiary of the 25324
policy. The department may pay premiums to keep the policy in 25325
force. Premiums paid by the department are medical assistance25326
medicaid payments correctly paid on behalf of a medical assistance25327
medicaid recipient and subject to recovery under section 5111.1125328
5162.40 of the Revised Code.25329

       (D) The director of job and family serviceshealth care 25330
administration shall deposit the proceeds of a life insurance 25331
policy that do not exceed the amount the department may recover 25332
against the property and estate of the owner under section 5111.1125333
5162.40 of the Revised Code into the general revenue fund. The 25334
director shall pay any remaining proceeds to the person designated 25335
by the owner. If the owner failed to designate a person, the 25336
director shall pay the remaining proceeds to the surviving spouse, 25337
or, if there is no surviving spouse, to the estate of the owner.25338

       (E) If the owner designates the department of job and family 25339
serviceshealth care administration as the policy's beneficiary, 25340
the department shall notify the owner that the owner may designate 25341
a person to receive proceeds of the policy that exceed the amount 25342
the department may recover against the owner's property and estate 25343
under section 5111.115162.40 of the Revised Code. The designation 25344
shall be made on a form provided by the department.25345

       (F) The department of job and family serviceshealth care 25346
administration shall not implement this section if implementation 25347
would violate any federal requirement unless the department 25348
receives a waiver of the requirement from the United States 25349
department of health and human services.25350

       Sec. 5111.0112.        Sec. 5162.35.  (A) The director of job and family 25351
serviceshealth care administration shall institute a 25352
cost-sharing program under the medicaid program. In instituting 25353
the cost-sharing program, the director shall comply with federal 25354
law. In the case of an individual participating in the 25355
children's buy-in program established under sections 5101.5211 25356
to 5101.5216 of the Revised Code, the cost-sharing program 25357
shall be consistent with sections 5101.52135167.37 and 25358
5101.52145167.38 of the Revised Code if the children's buy-in 25359
program is a component of the medicaid program. The cost-sharing 25360
program shall establish a copayment requirement for at least 25361
dental services, vision services, nonemergency emergency 25362
department services, and prescription drugs, other than generic 25363
drugs. The cost-sharing program shall establish requirements 25364
regarding premiums, enrollment fees, deductions, and similar 25365
charges. The director shall adopt rules under section 5111.0225366
5162.20 of the Revised Code governing the cost-sharing program.25367

       (B) The cost-sharing program shall, to the extent permitted 25368
by federal law, provide for all of the following with regard to 25369
any providers participating in the medicaid program:25370

        (1) No provider shall refuse to provide a service to a 25371
medicaid recipient who is unable to pay a required copayment for 25372
the service.25373

        (2) Division (B)(1) of this section shall not be considered 25374
to do either of the following with regard to a medicaid recipient 25375
who is unable to pay a required copayment:25376

       (a) Relieve the medicaid recipient from the obligation to pay 25377
a copayment;25378

        (b) Prohibit the provider from attempting to collect an 25379
unpaid copayment.25380

        (3) Except as provided in division (C) of this section, no 25381
provider shall waive a medicaid recipient's obligation to pay the 25382
provider a copayment.25383

        (4) No provider or drug manufacturer, including the 25384
manufacturer's representative, employee, independent contractor, 25385
or agent, shall pay any copayment on behalf of a medicaid 25386
recipient.25387

        (5) If it is the routine business practice of the provider to 25388
refuse service to any individual who owes an outstanding debt to 25389
the provider, the provider may consider an unpaid copayment 25390
imposed by the cost-sharing program as an outstanding debt and 25391
may refuse service to a medicaid recipient who owes the provider 25392
an outstanding debt. If the provider intends to refuse service to 25393
a medicaid recipient who owes the provider an outstanding debt, 25394
the provider shall notify the individual of the provider's intent 25395
to refuse services.25396

       (C) In the case of a provider that is a hospital, the 25397
cost-sharing program shall permit the hospital to take action to 25398
collect a copayment by providing, at the time services are 25399
rendered to a medicaid recipient, notice that a copayment may be 25400
owed. If the hospital provides the notice and chooses not to take 25401
any further action to pursue collection of the copayment, the 25402
prohibition against waiving copayments specified in division 25403
(B)(3) of this section does not apply.25404

       (D) The department of job and family serviceshealth care 25405
administration may work with a state agency that is 25406
administering, pursuant to a contract entered into under section 25407
5111.915161.05 of the Revised Code, one or more components of 25408
the medicaid program or one or more aspects of a component as 25409
necessary for the state agency to apply the cost-sharing program 25410
to the components or aspects of the medicaid program that the 25411
state agency administers.25412

       Sec. 5111.114.        Sec. 5162.36.  As used in this section, "nursing25413
facility" and "intermediate care facility for the mentally25414
retarded" have the same meanings as in section 5111.205164.01 of 25415
the Revised Code.25416

       In determining the amount of income that a medicaid recipient 25417
of medical assistance must apply monthly toward payment of the25418
cost of care in a nursing facility or intermediate care facility 25419
for the mentally retarded, the county department of job and family25420
services shall deduct from the recipient's monthly income a25421
monthly personal needs allowance in accordance with section 1902 25422
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 25423
1396a, as amended1396a(q).25424

       For a resident of a nursing facility, the monthly personal 25425
needs allowance shall be not less than forty dollars for an 25426
individual resident and not less than eighty dollars for a married 25427
couple if both spouses are residents of a nursing facility.25428

       For a resident of an intermediate care facility for the 25429
mentally retarded, the monthly personal needs allowance shall be 25430
forty dollars unless the resident has earned income, in which case 25431
the monthly personal needs allowance shall be determined by the 25432
state department of job and family serviceshealth care 25433
administration but shall not exceed one hundred five dollars.25434

       Sec. 5111.113.        Sec. 5162.37.  (A) As used in this section:25435

       (1) "Adult care facility" has the same meaning as in section 25436
3722.01 of the Revised Code.25437

       (2) "Commissioner" means a person appointed by a probate25438
court under division (B) of section 2113.03 of the Revised Code to 25439
act as a commissioner.25440

       (3) "Home" has the same meaning as in section 3721.10 of the 25441
Revised Code.25442

       (4) "Personal needs allowance account" means an account or 25443
petty cash fund that holds the money of a resident of an adult 25444
care facility or home and that the facility or home manages for 25445
the resident.25446

       (B) Except as provided in divisions (C) and (D) of this 25447
section, the owner or operator of an adult care facility or home 25448
shall transfer to the department of job and family serviceshealth 25449
care administration the money in the personal needs allowance 25450
account of a resident of the facility or home who was a medicaid25451
recipient of the medical assistance program no earlier than sixty 25452
days but not later than ninety days after the resident dies. The 25453
adult care facility or home shall transfer the money even though 25454
the owner or operator of the facility or home has not been issued 25455
letters testamentary or letters of administration concerning the 25456
resident's estate.25457

       (C) If funeral or burial expenses for a resident of an adult 25458
care facility or home who has died have not been paid and the only 25459
resource the resident had that could be used to pay for the 25460
expenses is the money in the resident's personal needs allowance 25461
account, or all other resources of the resident are inadequate to 25462
pay the full cost of the expenses, the money in the resident's 25463
personal needs allowance account shall be used to pay for the 25464
expenses rather than being transferred to the department of job 25465
and family serviceshealth care administration pursuant to 25466
division (B) of this section.25467

       (D) If, not later than sixty days after a resident of an 25468
adult care facility or home dies, letters testamentary or letters 25469
of administration are issued, or an application for release from 25470
administration is filed under section 2113.03 of the Revised Code, 25471
concerning the resident's estate, the owner or operator of the 25472
facility or home shall transfer the money in the resident's 25473
personal needs allowance account to the administrator, executor, 25474
commissioner, or person who filed the application for release from 25475
administration.25476

       (E) The transfer or use of money in a resident's personal 25477
needs allowance account in accordance with division (B), (C), or25478
(D) of this section discharges and releases the adult care 25479
facility or home, and the owner or operator of the facility or 25480
home, from any claim for the money from any source.25481

       (F) If, sixty-one or more days after a resident of an adult 25482
care facility or home dies, letters testamentary or letters of 25483
administration are issued, or an application for release from 25484
administration under section 2113.03 of the Revised Code is filed, 25485
concerning the resident's estate, the department of job and family 25486
serviceshealth care administration shall transfer the funds to 25487
the administrator, executor, commissioner, or person who filed 25488
the application, unless the department is entitled to recover the 25489
money under the medicaid estate recovery program instituted under 25490
section 5111.115162.40 of the Revised Code.25491

       Sec. 5111.11.        Sec. 5162.40.  (A) As used in this section and 25492
section 5111.111 of the Revised Code:25493

       (1) "Estate" includes both of the following:25494

       (a) All real and personal property and other assets to be25495
administered under Title XXI of the Revised Code and property that 25496
would be administered under that title if not for section 2113.03 25497
or 2113.031 of the Revised Code;25498

        (b) Any other real and personal property and other assets in 25499
which an individual had any legal title or interest at the time of 25500
death (to the extent of the interest), including assets conveyed 25501
to a survivor, heir, or assign of the individual through joint 25502
tenancy, tenancy in common, survivorship, life estate, living 25503
trust, or other arrangement.25504

        (2) "Institution" means a nursing facility, intermediate care 25505
facility for the mentally retarded, or a medical institution.25506

        (3) "Intermediate care facility for the mentally retarded" 25507
and "nursing facility" have the same meanings as in section 25508
5111.205164.01 of the Revised Code.25509

        (4) "Permanently institutionalized individual" means an 25510
individual to whom all of the following apply:25511

        (a) Is an inpatient in an institution;25512

        (b) Is required, as a condition of the medicaid program 25513
paying for the individual's services in the institution, to spend 25514
for costs of medical or nursing care all of the individual's 25515
income except for an amount for personal needs specified by the 25516
department of job and family serviceshealth care administration;25517

        (c) Cannot reasonably be expected to be discharged from the 25518
institution and return home as determined by the department of job 25519
and family serviceshealth care administration.25520

       (5) "Qualified state long-term care insurance partnership 25521
program" means the program established under section 5111.1825522
5162.43 of the Revised Code.25523

       (6) "Time of death" shall not be construed to mean a time 25524
after which a legal title or interest in real or personal property 25525
or other asset may pass by survivorship or other operation of law 25526
due to the death of the decedent or terminate by reason of the 25527
decedent's death.25528

       (B) To the extent permitted by federal law, the department of 25529
job and family serviceshealth care administration shall institute 25530
a medicaid estate recovery program under which the department 25531
shall, except as provided in divisions (C) and (E) of this 25532
section, and subject to division (D) of this section, do all of 25533
the following:25534

        (1) For the costs of medicaid services the medicaid program 25535
correctly paid or will pay on behalf of a permanently 25536
institutionalized individual of any age, seek adjustment or 25537
recovery from the individual's estate or on the sale of property 25538
of the individual or spouse that is subject to a lien imposed 25539
under section 5111.1115162.41 of the Revised Code;25540

        (2) For the costs of medicaid services the medicaid program 25541
correctly paid or will pay on behalf of an individual fifty-five 25542
years of age or older who is not a permanently institutionalized 25543
individual, seek adjustment or recovery from the individual's 25544
estate;25545

       (3) Seek adjustment or recovery from the estate of other 25546
individuals as permitted by federal law.25547

        (C)(1) No adjustment or recovery may be made under division 25548
(B)(1) of this section from a permanently institutionalized 25549
individual's estate or on the sale of property of a permanently 25550
institutionalized individual that is subject to a lien imposed 25551
under section 5111.1115162.41 of the Revised Code or under 25552
division (B)(2) or (3) of this section from an individual's 25553
estate while either of the following are alive:25554

        (a) The spouse of the permanently institutionalized 25555
individual or individual;25556

        (b) The son or daughter of a permanently institutionalized 25557
individual or individual if the son or daughter is under age 25558
twenty-one or, under 42 U.S.C. 1382c, is considered blind or 25559
disabled.25560

        (2) No adjustment or recovery may be made under division 25561
(B)(1) of this section from a permanently institutionalized 25562
individual's home that is subject to a lien imposed under section 25563
5111.1115162.41 of the Revised Code while either of the following 25564
lawfully reside in the home:25565

        (a) The permanently institutionalized individual's sibling 25566
who resided in the home for at least one year immediately before 25567
the date of the permanently institutionalized individual's 25568
admission to the institution and on a continuous basis since that 25569
time;25570

        (b) The permanently institutionalized individual's son or 25571
daughter who provided care to the permanently institutionalized 25572
individual that delayed the permanently institutionalized 25573
individual's institutionalization and resided in the home for at 25574
least two years immediately before the date of the permanently 25575
institutionalized individual's admission to the institution and on 25576
a continuous basis since that time.25577

        (D) In the case of a participant of the qualified state 25578
long-term care insurance partnership program, adjustment or 25579
recovery required by this section may be reduced in accordance 25580
with rules adopted under division (G) of this section.25581

        (E) The department shall, in accordance with procedures and 25582
criteria established in rules adopted under division (G) of this 25583
section, waive seeking an adjustment or recovery otherwise 25584
required by this section if the director of job and family25585
serviceshealth care administration determines that adjustment or25586
recovery would work an undue hardship. The department may limit 25587
the duration of the waiver to the period during which the undue 25588
hardship exists.25589

       (F) For the purpose of determining whether an individual 25590
meets the definition of "permanently institutionalized individual" 25591
established for this section, a rebuttable presumption exists that 25592
the individual cannot reasonably be expected to be discharged from 25593
an institution and return home if either of the following is the 25594
case:25595

       (1) The individual declares that he or she does not intend to 25596
return home.25597

       (2) The individual has been an inpatient in an institution 25598
for at least six months.25599

       (G) The director of job and family serviceshealth care 25600
administration shall adopt rules in accordance with Chapter 119. 25601
of the Revised Code regarding the medicaid estate recovery 25602
program, including rules that do both of the following:25603

        (1) For the purpose of division (D) of this section and 25604
consistent with 42 U.S.C. 1396p(b)(1)(C), provide for reducing an 25605
adjustment or recovery in the case of a participant of the 25606
qualified state long-term care insurance partnership program;25607

        (2) For the purpose of division (E) of this section and 25608
consistent with the standards specified by the United States 25609
secretary of health and human services under 42 U.S.C. 25610
1396p(b)(3), establish procedures and criteria for waiving 25611
adjustment or recovery due to an undue hardship.25612

       Sec. 5111.111.        Sec. 5162.41.  (A) Except as provided in division 25613
(B) of this section and section 5111.125162.45 of the Revised 25614
Code, no lien may be imposed against the property of an individual 25615
before the individual's death on account of medicaid services 25616
correctly paid or to be paid on the individual's behalf.25617

        (B) Except as provided in division (C) of this section, the 25618
department of job and family serviceshealth care administration25619
may impose a lien against the real property of a medicaid 25620
recipient who is a permanently institutionalized individual and 25621
against the real property of the recipient's spouse, including any 25622
real property that is jointly held by the recipient and spouse. 25623
The lien may be imposed on account of medicaid paid or to be paid 25624
on the recipient's behalf.25625

        (C) No lien may be imposed under division (B) of this section 25626
against the home of a medicaid recipient if any of the following 25627
lawfully resides in the home:25628

        (1) The recipient's spouse;25629

        (2) The recipient's son or daughter who is under twenty-one 25630
years of age or, under 42 U.S.C. 1382c, considered to be blind or 25631
disabled;25632

        (3) The recipient's sibling who has an equity interest in the 25633
home and resided in the home for at least one year immediately 25634
before the date of the recipient's admission to the institution.25635

        (D) The director of job and family serviceshealth care 25636
administration or a person designated by the director shall sign a 25637
certificate to effectuate a lien required to be imposed under this 25638
section. The county department of job and family services shall 25639
file for recording and indexing the certificate, or a certified 25640
copy, in the real estate mortgage records in the office of the 25641
county recorder in every county in which real property of the 25642
recipient or spouse is situated. From the time of filing the25643
certificate in the office of the county recorder, the lien25644
attaches to all real property of the recipient or spouse described 25645
in the certificate for all amounts for which adjustment or 25646
recovery may be made under section 5111.115162.40 of the Revised 25647
Code and, except as provided in division (E) of this section, 25648
shall remain a lien until satisfied.25649

       Upon filing the certificate in the office of the recorder,25650
all persons are charged with notice of the lien and the rights of25651
the department of job and family serviceshealth care 25652
administration thereunder.25653

       The county recorder shall keep a record of every certificate 25654
filed showing its date, the time of filing, the name and residence 25655
of the recipient or spouse, and any release, waivers, or 25656
satisfaction of the lien.25657

       The priority of the lien shall be established in accordance 25658
with state and federal law.25659

       The department may waive the priority of its lien to provide 25660
for the costs of the last illness as determined by the department, 25661
administration, attorney fees, administrator fees, a sum for the 25662
payment of the costs of burial, which shall be computed by 25663
deducting from five hundred dollars whatever amount is available 25664
for the same purpose from all other sources, and a similar sum for 25665
the spouse of the decedent.25666

       (E) A lien imposed with respect to a medicaid recipient under 25667
this section shall dissolve on the recipient's discharge from the 25668
institution and return home.25669

       Sec. 5111.112.        Sec. 5162.42.  The department of job and family 25670
serviceshealth care administration shall certify amounts due 25671
under the medicaid estate recovery program instituted under 25672
section 5111.115162.40 of the Revised Code to the attorney 25673
general pursuant to section 131.02 of the Revised Code. The 25674
attorney general may enter into a contract with any person or 25675
government entity to collect the amounts due on behalf of the 25676
attorney general.25677

        The attorney general, in entering into a contract under this 25678
section, shall comply with all of the requirements that must be 25679
met for the state to receive federal financial participation for 25680
the costs incurred in entering into the contract and carrying out 25681
actions under the contract. The contract may provide for the 25682
person or government entity with which the attorney general 25683
contracts to be compensated from the property recovered under the 25684
medicaid estate recovery program or may provide for another manner 25685
of compensation agreed to by the parties to the contract.25686

        Regardless of whether the attorney general collects the 25687
amounts due under the medicaid estate recovery program or 25688
contracts with a person or government entity to collect the 25689
amounts due on behalf of the attorney general, the amounts due 25690
shall be collected in accordance with applicable requirements of 25691
federal statutes and regulations and state statutes and rules.25692

       Sec. 5111.18.        Sec. 5162.43. Not later than September 1, 2007, the 25693
director of job and family serviceshealth care administration25694
shall establish a qualified state long-term care insurance 25695
partnership program consistent with the definition of that term in 25696
42 U.S.C. 1396p(b)(1)(C)(iii). An individual participating in the 25697
program who is subject to the medicaid estate recovery program 25698
instituted under section 5111.115162.40 of the Revised Code shall 25699
be eligible for the reduced adjustment or recovery under division 25700
(D) of that section.25701

        The director of job and family serviceshealth care 25702
administration may adopt rules in accordance with Chapter 119. of 25703
the Revised Code as necessary to implement this section.25704

       Sec. 5111.12.        Sec. 5162.45.  (A) The director of job and family25705
serviceshealth care administration shall establish rules under 25706
which county departments of job and family services may take 25707
action to recover benefits incorrectly paid on behalf of medicaid25708
recipients of medical assistance. The rules shall provide for25709
recovery by the following methods:25710

       (1) Soliciting voluntary payments from recipients or from25711
persons holding property in which a recipient has a legal or25712
equitable interest;25713

       (2) Obtaining a lien on property pursuant to division (B) of 25714
this section.25715

       (B) A county department of job and family services may bring 25716
a civil action in a court of common pleas against a medicaid25717
recipient of medical assistance for the recovery of any medical 25718
assistancemedicaid benefits determined by the court to have been 25719
paid incorrectly on behalf of the recipient. All persons holding 25720
property in which the recipient has a legal or equitable interest 25721
may be joined as parties. The court may issue pre-judgment orders, 25722
including injunctive relief or attachment under Chapter 2715. of 25723
the Revised Code, for the preservation of real or personal 25724
property in which the recipient may have a legal or equitable 25725
interest. If the court determines that benefits were paid 25726
incorrectly and issues a judgment to that effect, the county 25727
department may obtain a lien upon property of the recipient in 25728
accordance with Chapter 2329. of the Revised Code.25729

       (C) The county department of job and family services shall 25730
retain fifty per cent of the balance remaining after deduction 25731
from the recovery of the amount required to be returned to the 25732
federal government and shall pay the other fifty per cent of the 25733
balance to the department of job and family serviceshealth care 25734
administration.25735

       (D) Recovery of medical assistancemedicaid benefits 25736
incorrectly paid to a recipient may not be accomplished by 25737
reducing the amount of benefits the recipient is entitled to 25738
receive under another government assistance program.25739

       (E) The remedies provided pursuant to this section do not25740
affect any other remedies county departments of job and family 25741
services may have to recover benefits incorrectly paid on behalf 25742
of medicaid recipients of medical assistance.25743

       Sec. 5111.06.        Sec. 5163.01.  (A)(1) As used in this section and in 25744
sections 5111.0615163.07 and 5111.0625163.09 of the Revised 25745
Code:25746

       (a) "Provider" means any person, institution, or entity that25747
furnishes medicaid services under a medicaid provider agreement 25748
with the department of job and family services pursuant to Title 25749
XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 25750
301, as amendedhealth care administration.25751

       (b) "Party" has the same meaning as in division (G) of25752
section 119.01 of the Revised Code.25753

       (c) "Adjudication" has the same meaning as in division (D) of 25754
section 119.01 of the Revised Code.25755

       (2) This section does not apply to any action taken by the25756
department of job and family serviceshealth care administration25757
under sections 5111.355164.50 to 5111.625164.78 of the Revised 25758
Code.25759

       (B) Except as provided in division (D) of this section and 25760
section 5111.9145163.06 of the Revised Code, the department shall 25761
do either of the following by issuing an order pursuant to an 25762
adjudication conducted in accordance with Chapter 119. of the 25763
Revised Code:25764

       (1) Enter into or refuse to enter into a medicaid provider25765
agreement with a provider, or suspend, terminate, renew, or refuse 25766
to renew an existing medicaid provider agreement with a provider;25767

       (2) Take any action based upon a final fiscal audit of a25768
provider.25769

       (C) Any party who is adversely affected by the issuance of an 25770
adjudication order under division (B) of this section may appeal 25771
to the court of common pleas of Franklin county in accordance with 25772
section 119.12 of the Revised Code.25773

       (D) The department is not required to comply with division25774
(B)(1) of this section whenever any of the following occur:25775

       (1) The terms of a medicaid provider agreement require the 25776
provider to hold a license, permit, or certificate or maintain a 25777
certification issued by an official, board, commission, 25778
department, division, bureau, or other agency of state or federal 25779
government other than the department of job and family services25780
health care administration, and the license, permit, certificate, 25781
or certification has been denied, revoked, not renewed, 25782
suspended, or otherwise limited.25783

       (2) The terms of a medicaid provider agreement require the 25784
provider to hold a license, permit, or certificate or maintain 25785
certification issued by an official, board, commission, 25786
department, division, bureau, or other agency of state or federal 25787
government other than the department of job and family services25788
health care administration, and the provider has not obtained the 25789
license, permit, certificate, or certification.25790

       (3) The medicaid provider agreement is denied, terminated, or 25791
not renewed due to the termination, refusal to renew, or denial 25792
of a license, permit, certificate, or certification by an 25793
official, board, commission, department, division, bureau, or 25794
other agency of this state other than the department of job and 25795
family serviceshealth care administration, notwithstanding the 25796
fact that the provider may hold a license, permit, certificate, 25797
or certification from an official, board, commission, department, 25798
division, bureau, or other agency of another state.25799

       (4) The medicaid provider agreement is denied, terminated, or 25800
not renewed pursuant to division (C) or (F) of section 5111.0325801
5163.03 of the Revised Code;25802

       (5) The medicaid provider agreement is denied, terminated, or 25803
not renewed due to the provider's termination, suspension, or25804
exclusion from the medicare program established under Title XVIII25805
of the "Social Security Act," and the termination, suspension, or25806
exclusion is binding on the provider's participation in the25807
medicaid program;25808

       (6) The medicaid provider agreement is denied, terminated, or 25809
not renewed due to the provider's pleading guilty to or being25810
convicted of a criminal activity materially related to either the25811
medicare or medicaid program;25812

       (7) The medicaid provider agreement is denied, terminated, or25813
suspended as a result of action by the United States department of25814
health and human services and that action is binding on the25815
provider's participation in the medicaid program;25816

       (8) The medicaid provider agreement is suspended pursuant to 25817
section 5111.0315163.031 of the Revised Code pending indictment 25818
of the provider.25819

       (9) The medicaid provider agreement is denied, terminated, or 25820
not renewed because the provider has been convicted of one of the 25821
offenses that caused the provider agreement to be suspended 25822
pursuant to section 5111.0315163.031 of the Revised Code.25823

       (10) The medicaid provider agreement is converted under 25824
section 5111.0285163.011 of the Revised Code from a provider 25825
agreement that is not time-limited to a provider agreement that 25826
is time-limited.25827

       (11) The medicaid provider agreement is terminated or an 25828
application for re-enrollment is denied because the provider has 25829
failed to apply for re-enrollment within the time or in the 25830
manner specified for re-enrollment pursuant to section 5111.02825831
5163.011 of the Revised Code.25832

       (12) The medicaid provider agreement is terminated or not 25833
renewed because the provider has not billed or otherwise 25834
submitted a medicaid claim to the department for two years or 25835
longer, and the department has determined that the provider has 25836
moved from the address on record with the department without 25837
leaving an active forwarding address with the department.25838

       In the case of a provider described in division (D)(12) of 25839
this section, the department may terminate or not renew the 25840
medicaid provider agreement by sending a notice explaining the 25841
department's proposed action to the address on record with the 25842
department. The notice may be sent by regular mail.25843

       (E) The department may withhold payments for services25844
rendered by a medicaid provider under the medical assistance25845
medicaid program during the pendency of proceedings initiated 25846
under division (B)(1) of this section. If the proceedings are25847
initiated under division (B)(2) of this section, the department25848
may withhold payments only to the extent that they equal amounts25849
determined in a final fiscal audit as being due the state. This25850
division does not apply if the department fails to comply with25851
section 119.07 of the Revised Code, requests a continuance of the25852
hearing, or does not issue a decision within thirty days after the 25853
hearing is completed. This division does not apply to nursing 25854
facilities and intermediate care facilities for the mentally 25855
retarded as defined in section 5111.205164.01 of the Revised 25856
Code.25857

       Sec. 5111.028.        Sec. 5163.011. (A) Pursuant to section 5111.0225858
5163.15 of the Revised Code, the director of job and family 25859
serviceshealth care administration shall adopt rules 25860
establishing procedures for the use of time-limited provider 25861
agreements under the medicaid program. Except as provided in 25862
division (E) of this section, all provider agreements shall be 25863
time-limited in accordance with the procedures established in the 25864
rules.25865

       The department of job and family serviceshealth care 25866
administration shall phase-in the use of time-limited provider 25867
agreements pursuant to this section during a period commencing 25868
not later than January 1, 2008, and ending January 1, 2011.25869

       (B) In the use of time-limited provider agreements pursuant 25870
to this section, all of the following apply:25871

       (1) Each provider agreement shall expire not later than 25872
three years from the effective date of the agreement.25873

       (2) During the phase-in period specified in division (A) of 25874
this section, the department may provide for the conversion of a 25875
provider agreement without a time limit to a provider agreement 25876
with a time limit. The department may take an action to convert 25877
the provider agreement by sending a notice by regular mail to the 25878
address of the provider on record with the department advising the 25879
provider of the conversion.25880

       (3) The department may make the effective date of a provider 25881
agreement retroactive for a period not to exceed one year from the 25882
date of the provider's application for the agreement, as long as 25883
the provider met all medicaid program requirements during that 25884
period.25885

        (C) The rules for use of time-limited provider agreements 25886
pursuant to this section shall include a process for re-enrollment 25887
of providers. All of the following apply to the re-enrollment 25888
process:25889

       (1) The department of job and family serviceshealth care 25890
administration may terminate a time-limited provider agreement 25891
or deny re-enrollment when a provider fails to file an 25892
application for re-enrollment within the time and in the manner 25893
required under the re-enrollment process.25894

       (2) If a provider files an application for re-enrollment 25895
within the time and in the manner required under the re-enrollment 25896
process, but the provider agreement expires before the department 25897
acts on the application or before the effective date of the 25898
department's decision on the application, the provider may 25899
continue operating under the terms of the expired provider 25900
agreement until the effective date of the department's decision.25901

       (3) A decision by the department to approve an application 25902
for re-enrollment becomes effective on the date of the 25903
department's decision. A decision by the department to deny 25904
re-enrollment shall take effect not sooner than thirty days after 25905
the date the department mails written notice of the decision to 25906
the provider. The department shall specify in the notice the date 25907
on which the provider is required to cease operating under the 25908
provider agreement.25909

       (D) Pursuant to section 5111.065163.01 of the Revised Code, 25910
the department is not required to take the actions specified in 25911
division (C)(1) of this section by issuing an order pursuant to an 25912
adjudication conducted in accordance with Chapter 119. of the 25913
Revised Code.25914

       (E) The use of time-limited provider agreements pursuant to 25915
this section does not apply to provider agreements issued to the 25916
following, including any provider agreements issued to the 25917
following that are otherwise time-limited under the medicaid 25918
program:25919

       (1) A managed care organization under contract with the 25920
department pursuant to section 5111.175165.05 of the Revised 25921
Code;25922

       (2) A nursing facility, as defined in section 5111.205164.0125923
of the Revised Code;25924

       (3) An intermediate care facility for the mentally retarded, 25925
as defined in section 5111.205164.01 of the Revised Code.25926

       Sec. 5111.05.        Sec. 5163.02.  (A) The department of job and family 25927
serviceshealth care administration may contract with any person 25928
or persons as a fiscal agent for the examination, processing, and 25929
determination of medical assistancemedicaid claims under this 25930
chapter. The contracting party may provide any of the following 25931
services, as required by the contract:25932

       (1) Design and operate medicaid management information25933
systems, including the provision of data processing services;25934

       (2) Determine the amounts of payments to be made upon claims 25935
for medical assistancemedicaid;25936

       (3) Prepare and furnish to the department lists and computer 25937
tapes of such claims for payment;25938

       (4) In addition to audits which may be conducted by the25939
department and by the auditor of state, make audits of providers25940
and the claims of medicaid providers of medical assistance25941
according to the standards set forth in the contract;25942

       (5) Assist medicaid providers of medical assistance in the25943
development of procedures relating to utilization practices, make25944
studies of the effectiveness of such procedures and methods for25945
their improvement, implement and enforce standards of medical25946
policy, and assist in the application of safeguards against25947
unnecessary utilization;25948

       (6) Assist any institution, facility, or agency to qualify as 25949
a medicaid provider of medical assistance;25950

       (7) Establish and maintain fiscal records for the medical25951
assistancemedicaid program;25952

       (8) Perform statistical and research studies;25953

       (9) Develop and implement programs for medical assistance25954
medicaid cost containment;25955

       (10) Perform such other duties as are necessary to carry out 25956
the medical assistancemedicaid program.25957

       (B) The department of job and family serviceshealth care 25958
administration may contract with any person or persons as an 25959
insuring agent for the examination, processing, and determination 25960
of medical assistancemedicaid claims, as provided in division (A) 25961
of this section, and for the payment of medical assistance25962
medicaid claims through an underwritten program in which the state 25963
pays the insuring agent a monthly premium and the insuring agent 25964
pays for medical services authorized under the state's medical 25965
assistancemedicaid program. The person with whom the department 25966
contracts, with respect to the awarding, provisions, and 25967
performance of such contract, shall not be subject to the25968
provisions of Title XXXIX of the Revised Code or to regulation by25969
the department of insurance, nor to taxation as an insurance25970
company pursuant to section 5725.18 or 5729.03 of the Revised25971
Code. A contract with an insuring agent shall specify the25972
qualifications, including capital and surplus requirements, and25973
other conditions with which the insuring agent must comply.25974

       (C) In entering into a contract under this section, the25975
department, in cooperation with the director of budget and25976
management, shall determine that the contracting party is25977
qualified to perform the required services and shall follow25978
applicable procedures required of the department of administrative 25979
services in sections 125.07 to 125.11 of the Revised Code. A 25980
contract shall be awarded to the bidder who, with due 25981
consideration to the bidder's experience and financial capability, 25982
offers the lowest and best bid to the state for control of the 25983
costs of the medical assistancemedicaid program consistent with 25984
meeting the obligations under that program for fair and equitable 25985
treatment of recipients and providers of medical services. Any 25986
arrangement whereby funds are paid to an insuring or fiscal agent 25987
for administrative functions under this section shall, for the 25988
purposes of section 125.081 of the Revised Code, be deemed to be a 25989
contract or purchase by the department of administrative services; 25990
however, money to be used by an insuring agent to pay for medical 25991
services authorized under the state's medical assistancemedicaid25992
program shall not be deemed a contract or purchase within the 25993
meaning of such section.25994

       Sec. 5111.03.        Sec. 5163.03.  (A) No provider of services or goods25995
contracting with the department of job and family serviceshealth 25996
care administration pursuant to the medicaid program shall, by 25997
deception, obtain or attempt to obtain payments under this 25998
chapter to which the provider is not entitled pursuant to the 25999
provider agreement, or the rules of the federal government or the 26000
department of job and family serviceshealth care administration26001
relating to the program. No provider shall willfully receive 26002
payments to which the provider is not entitled, or willfully 26003
receive payments in a greater amount than that to which the 26004
provider is entitled; nor shall any provider falsify any report 26005
or document required by state or federal law, rule, or provider 26006
agreement relating to medicaid payments. As used in this section, 26007
a provider engages in "deception" when the provider, acting with 26008
actual knowledge of the representation or information involved, 26009
acting in deliberate ignorance of the truth or falsity of the 26010
representation or information involved, or acting in reckless 26011
disregard of the truth or falsity of the representation or 26012
information involved, deceives another or causes another to be 26013
deceived by any false or misleading representation, by withholding 26014
information, by preventing another from acquiring information, or 26015
by any other conduct, act, or omission that creates, confirms, or 26016
perpetuates a false impression in another, including a false 26017
impression as to law, value, state of mind, or other objective or 26018
subjective fact. No proof of specific intent to defraud is 26019
required to show, for purposes of this section, that a provider 26020
has engaged in deception.26021

       (B) Any provider who violates division (A) of this section26022
shall be liable, in addition to any other penalties provided by26023
law, for all of the following civil penalties:26024

       (1) Payment of interest on the amount of the excess payments 26025
at the maximum interest rate allowable for real estate mortgages 26026
under section 1343.01 of the Revised Code on the date the payment 26027
was made to the provider for the period from the date upon which 26028
payment was made, to the date upon which repayment is made to the 26029
state;26030

       (2) Payment of an amount equal to three times the amount of 26031
any excess payments;26032

       (3) Payment of a sum of not less than five thousand dollars 26033
and not more than ten thousand dollars for each deceptive claim or 26034
falsification;26035

       (4) All reasonable expenses which the court determines have 26036
been necessarily incurred by the state in the enforcement of this 26037
section.26038

       (C) As used in this division, "intermediate care facility for 26039
the mentally retarded" and "nursing facility" have the same 26040
meanings given in section 5111.205164.01 of the Revised Code.26041

       In addition to the civil penalties provided in division (B) 26042
of this section, the director of job and family serviceshealth 26043
care administration, upon the conviction of, or the entry of a 26044
judgment in either a criminal or civil action against, a medicaid 26045
provider or its owner, officer, authorized agent, associate, 26046
manager, or employee in an action brought pursuant to section 26047
109.85 of the Revised Code, shall terminate the provider 26048
agreement between the department and the provider and stop 26049
reimbursement to the provider for services rendered from the 26050
date of conviction or entry of judgment. As used in this 26051
division, "owner" means any person having at least five per cent 26052
ownership in the medicaid provider. No such provider, owner, 26053
officer, authorized agent, associate, manager, or employee shall 26054
own or provide services to any other medicaid provider or risk 26055
contractor or arrange for, render, or order services for26056
medicaid recipients, nor shall such provider, owner, officer, 26057
authorized agent, associate, manager, or employee receive 26058
reimbursement in the form of direct payments from the department 26059
or indirect payments of medicaid funds in the form of salary, 26060
shared fees, contracts, kickbacks, or rebates from or through any 26061
participating provider or risk contractor. The provider agreement 26062
shall not be terminated or reimbursement terminated if the 26063
provider or owner can demonstrate that the provider or owner did 26064
not directly or indirectly sanction the action of its authorized 26065
agent, associate, manager, or employee that resulted in the 26066
conviction or entry of a judgment in a criminal or civil action 26067
brought pursuant to section 109.85 of the Revised Code. Nothing in 26068
this division prohibits any owner, officer, authorized agent, 26069
associate, manager, or employee of a medicaid provider from 26070
entering into a medicaid provider agreement if the person can 26071
demonstrate that the person had no knowledge of an action of the 26072
medicaid provider the person was formerly associated with that 26073
resulted in the conviction or entry of a judgment in a criminal 26074
or civil action brought pursuant to section 109.85 of the Revised 26075
Code.26076

        Nursing facility or intermediate care facility for the 26077
mentally retarded providers whose agreements are terminated 26078
pursuant to this section may continue to receive reimbursement for 26079
up to thirty days after the effective date of the termination if 26080
the provider makes reasonable efforts to transfer recipients to 26081
another facility or to alternate care and if federal funds are 26082
provided for such reimbursement.26083

       (D) For any reason permitted or required by federal law, the 26084
director of job and family serviceshealth care administration may 26085
deny a provider agreement or terminate a provider agreement.26086

       For any reason permitted or required by federal law, the 26087
director may exclude an individual, provider of services or goods, 26088
or other entity from participation in the medicaid program. No 26089
individual, provider, or entity excluded under this division shall 26090
own or provide services to any other medicaid provider or risk 26091
contractor or arrange for, render, or order services for medicaid 26092
recipients during the period of exclusion, nor, during the period 26093
of exclusion, shall such individual, provider, or entity receive 26094
reimbursement in the form of direct payments from the department 26095
or indirect payments of medicaid funds in the form of salary, 26096
shared fees, contracts, kickbacks, or rebates from or through any 26097
participating provider or risk contractor. An excluded individual, 26098
provider, or entity may request a reconsideration of the 26099
exclusion. The director shall adopt rules in accordance with 26100
Chapter 119. of the Revised Code governing the process for 26101
requesting a reconsideration.26102

       Nothing in this division limits the applicability of section 26103
5111.06 of the Revised Code to a medicaid provider.26104

       (E) Any provider of services or goods contracting with the26105
department of job and family services pursuant to Title XIX of26106
health care administration under the "Social Security Act,"26107
medicaid program who, without intent, obtains payments under this26108
chapter in excess of the amount to which the provider is entitled, 26109
thereby becomes liable for payment of interest on the amount of 26110
the excess payments at the maximum real estate mortgage rate on 26111
the date the payment was made to the provider for the period from 26112
the date upon which payment was made to the date upon which 26113
repayment is made to the state.26114

       (F) The attorney general on behalf of the state may commence 26115
proceedings to enforce this section in any court of competent 26116
jurisdiction; and the attorney general may settle or compromise 26117
any case brought under this section with the approval of the 26118
department of job and family serviceshealth care administration. 26119
Notwithstanding any other provision of law providing a shorter 26120
period of limitations, the attorney general may commence a 26121
proceeding to enforce this section at any time within six years 26122
after the conduct in violation of this section terminates.26123

       (G) The authority, under state and federal law, of the26124
department of job and family serviceshealth care administration26125
or a county department of job and family services to recover 26126
excess payments made to a provider is not limited by the 26127
availability of remedies under sections 5111.115162.40 and 26128
5111.125162.45 of the Revised Code for recovering benefits paid 26129
on behalf of medicaid recipients of medical assistance.26130

       The penalties under this chapter apply to any overpayment,26131
billing, or falsification occurring on and after April 24, 1978.26132
All moneys collected by the state pursuant to this section shall26133
be deposited in the state treasury to the credit of the general26134
revenue fund.26135

       Sec. 5111.031.        Sec. 5163.031. (A) As used in this section:26136

       (1) "Independent provider" has the same meaning as in section 26137
5111.0345163.034 of the Revised Code.26138

       (2) "Intermediate care facility for the mentally retarded" 26139
and "nursing facility" have the same meanings as in section 26140
5111.205164.01 of the Revised Code.26141

       (3) "Noninstitutional medicaid provider" means any person or 26142
entity with a medicaid provider agreement other than a hospital, 26143
nursing facility, or intermediate care facility for the mentally 26144
retarded.26145

       (4) "Owner" means any person having at least five per cent 26146
ownership in a noninstitutional medicaid provider.26147

       (B) Notwithstanding any provision of this chapter to the 26148
contrary, the department of job and family serviceshealth care 26149
administration shall take action under this section against a 26150
noninstitutional medicaid provider or its owner, officer, 26151
authorized agent, associate, manager, or employee.26152

       (C) Except as provided in division (D) of this section and in 26153
rules adopted by the department under division (H) of this 26154
section, on receiving notice and a copy of an indictment that is 26155
issued on or after the effective date of this sectionSeptember 26156
29, 2007, and charges a noninstitutional medicaid provider or its 26157
owner, officer, authorized agent, associate, manager, or employee 26158
with committing an offense specified in division (E) of this 26159
section, the department shall suspend the provider agreement held 26160
by the noninstitutional medicaid provider. Subject to division 26161
(D) of this section, the department shall also terminate medicaid 26162
reimbursement to the provider for services rendered.26163

       The suspension shall continue in effect until the proceedings 26164
in the criminal case are completed through conviction, dismissal 26165
of the indictment, plea, or finding of not guilty. If the 26166
department commences a process to terminate the suspended provider 26167
agreement, the suspension shall continue in effect until the 26168
termination process is concluded. Pursuant to section 5111.0626169
5163.01 of the Revised Code, the department is not required to 26170
take action under this division by issuing an order pursuant to 26171
an adjudication conducted in accordance with Chapter 119. of the 26172
Revised Code.26173

       When subject to a suspension under this division, a provider, 26174
owner, officer, authorized agent, associate, manager, or employee 26175
shall not own or provide services to any other medicaid provider 26176
or risk contractor or arrange for, render, or order services for 26177
medicaid recipients during the period of suspension. During the 26178
period of suspension, the provider, owner, officer, authorized 26179
agent, associate, manager, or employee shall not receive 26180
reimbursement in the form of direct payments from the department 26181
or indirect payments of medicaid funds in the form of salary, 26182
shared fees, contracts, kickbacks, or rebates from or through any 26183
participating provider or risk contractor.26184

       (D)(1) The department shall not suspend a provider agreement 26185
or terminate medicaid reimbursement under division (C) of this 26186
section if the provider or owner can demonstrate that the provider 26187
or owner did not directly or indirectly sanction the action of its 26188
authorized agent, associate, manager, or employee that resulted in 26189
the indictment.26190

       (2) The termination of medicaid reimbursement applies only to 26191
payments for medicaid services rendered subsequent to the date on 26192
which the notice required under division (F) of this section is 26193
sent. Claims for reimbursement for medicaid services rendered by 26194
the provider prior to the issuance of the notice may be subject to 26195
prepayment review procedures whereby the department reviews claims 26196
to determine whether they are supported by sufficient 26197
documentation, are in compliance with state and federal statutes 26198
and rules, and are otherwise complete.26199

       (E)(1) In the case of a noninstitutional medicaid provider 26200
that is not an independent provider, the suspension of a provider 26201
agreement under division (C) of this section applies when an 26202
indictment charges a person with committing an act that would be a 26203
felony or misdemeanor under the laws of this state and the act 26204
relates to or results from either of the following:26205

       (a) Furnishing or billing for medical care, services, or 26206
supplies under the medicaid program;26207

       (b) Participating in the performance of management or 26208
administrative services relating to furnishing medical care, 26209
services, or supplies under the medicaid program.26210

       (2) In the case of a noninstitutional medicaid provider that 26211
is an independent provider, the suspension of a provider agreement 26212
under division (C) of this section applies when an indictment 26213
charges a person with committing an act that would constitute one 26214
of the offenses specified in division (D) of section 5111.03426215
5163.034 of the Revised Code.26216

       (F) Not later than five days after suspending a provider 26217
agreement under division (C) of this section, the department shall 26218
send notice of the suspension to the affected provider or owner. 26219
In providing the notice, the department shall do all of the 26220
following:26221

       (1) Describe the indictment that was the cause of the 26222
suspension, without necessarily disclosing specific information 26223
concerning any ongoing civil or criminal investigation;26224

       (2) State that the suspension will continue in effect until 26225
the proceedings in the criminal case are completed through 26226
conviction, dismissal of the indictment, plea, or finding of not 26227
guilty and, if the department commences a process to terminate the 26228
suspended provider agreement, until the termination process is 26229
concluded;26230

       (3) Inform the provider or owner of the opportunity to submit 26231
to the department, not later than thirty days after receiving the 26232
notice, a request for a reconsideration pursuant to division (G) 26233
of this section. 26234

       (G)(1) A noninstitutional medicaid provider or owner subject 26235
to a suspension under this section may request a reconsideration. 26236
The request shall be made not later than thirty days after receipt 26237
of the notice provided under division (F) of this section. The 26238
reconsideration is not subject to an adjudication hearing pursuant 26239
to Chapter 119. of the Revised Code.26240

       (2) In requesting a reconsideration, the provider or owner 26241
shall submit written information and documents to the department. 26242
The information and documents may pertain to any of the following 26243
issues:26244

       (a) Whether the determination to suspend the provider 26245
agreement was based on a mistake of fact, other than the validity 26246
of the indictment;26247

       (b) Whether any offense charged in the indictment resulted 26248
from an offense specified in division (E) of this section;26249

       (c) Whether the provider or owner can demonstrate that the 26250
provider or owner did not directly or indirectly sanction the 26251
action of its authorized agent, associate, manager, or employee 26252
that resulted in the indictment.26253

       (3) The department shall review the information and documents 26254
submitted in a request for reconsideration. After the review, the 26255
suspension may be affirmed, reversed, or modified, in whole or in 26256
part. The department shall notify the affected provider or owner 26257
of the results of the review. The review and notification of its 26258
results shall be completed not later than forty-five days after 26259
receiving the information and documents submitted in a request for 26260
reconsideration.26261

       (H) The department may adopt rules in accordance with Chapter 26262
119. of the Revised Code to implement this section. The rules may 26263
specify circumstances under which the department would not suspend 26264
a provider agreement pursuant to this section.26265

       Sec. 5111.032.        Sec. 5163.032. (A) As used in this section:26266

       (1) "Criminal records check" has the same meaning as in 26267
section 109.572 of the Revised Code.26268

       (2) "Department" includes a designee of the department of job 26269
and family serviceshealth care administration.26270

       (3) "Owner" means a person who has an ownership interest in a 26271
provider in an amount designated by the department of job and 26272
family serviceshealth care administration in rules adopted under 26273
this section.26274

       (4) "Provider" means a person, institution, or entity that 26275
has a medicaid provider agreement with the department of job and 26276
family services pursuant to Title XIX of the "Social Security 26277
Act," 49 State. 620 (1965), 42 U.S.C. 1396, as amendedhealth 26278
care administration.26279

       (B)(1) Except as provided in division (B)(2) of this section, 26280
the department of job and family serviceshealth care 26281
administration may require that any provider, applicant to be a 26282
provider, employee or prospective employee of a provider, owner 26283
or prospective owner of a provider, officer or prospective 26284
officer of a provider, or board member or prospective board 26285
member of a provider submit to a criminal records check as a 26286
condition of obtaining a provider agreement, continuing to hold a 26287
provider agreement, being employed by a provider, having an 26288
ownership interest in a provider, or being an officer or board 26289
member of a provider. The department may designate the categories 26290
of persons who are subject to the criminal records check 26291
requirement. The department shall designate the times at which 26292
the criminal records checks must be conducted.26293

       (2) The section does not apply to providers, applicants to be 26294
providers, employees of a provider, or prospective employees of a 26295
provider who are subject to criminal records checks under section 26296
5111.0335163.033 or 5111.0345163.034 of the Revised Code.26297

       (C)(1) The department shall inform each provider or applicant 26298
to be a provider whether the provider or applicant is subject to a 26299
criminal records check requirement under division (B) of this 26300
section. For providers, the information shall be given at times 26301
designated in rules adopted under this section. For applicants to 26302
be providers, the information shall be given at the time of 26303
initial application. When the information is given, the department 26304
shall specify which of the provider's or applicant's employees or 26305
prospective employees, owners or prospective owners, officers or 26306
prospective officers, or board members or prospective board 26307
members are subject to the criminal records check requirement.26308

       (2) At times designated in rules adopted under this section, 26309
a provider that is subject to the criminal records check 26310
requirement shall inform each person specified by the department 26311
under division (C)(1) of this section that the person is required, 26312
as applicable, to submit to a criminal records check for final 26313
consideration for employment in a full-time, part-time, or 26314
temporary position; as a condition of continued employment; or as 26315
a condition of becoming or continuing to be an officer, board 26316
member or owner of a provider.26317

       (D)(1) If a provider or applicant to be a provider is subject 26318
to a criminal records check under this section, the department 26319
shall require the conduct of a criminal records check by the 26320
superintendent of the bureau of criminal identification and 26321
investigation. If a provider or applicant to be a provider for 26322
whom a criminal records check is required does not present proof 26323
of having been a resident of this state for the five-year period 26324
immediately prior to the date the criminal records check is 26325
requested or provide evidence that within that five-year period 26326
the superintendent has requested information about the individual 26327
from the federal bureau of investigation in a criminal records 26328
check, the department shall require the provider or applicant to 26329
request that the superintendent obtain information from the 26330
federal bureau of investigation as part of the criminal records 26331
check of the provider or applicant. Even if a provider or 26332
applicant for whom a criminal records check request is required 26333
presents proof of having been a resident of this state for the 26334
five-year period, the department may require that the provider or 26335
applicant request that the superintendent obtain information from 26336
the federal bureau of investigation and include it in the criminal 26337
records check of the provider or applicant.26338

       (2) A provider shall require the conduct of a criminal 26339
records check by the superintendent with respect to each of the 26340
persons specified by the department under division (C)(1) of this 26341
section. If the person for whom a criminal records check is 26342
required does not present proof of having been a resident of this 26343
state for the five-year period immediately prior to the date the 26344
criminal records check is requested or provide evidence that 26345
within that five-year period the superintendent of the bureau of 26346
criminal identification and investigation has requested 26347
information about the individual from the federal bureau of 26348
investigation in a criminal records check, the individual shall 26349
request that the superintendent obtain information from the 26350
federal bureau of investigation as part of the criminal records 26351
check of the individual. Even if an individual for whom a criminal 26352
records check request is required presents proof of having been a 26353
resident of this state for the five-year period, the department 26354
may require the provider to request that the superintendent obtain 26355
information from the federal bureau of investigation and include 26356
it in the criminal records check of the person.26357

       (E)(1) Criminal records checks required under this section 26358
for providers or applicants to be providers shall be obtained as 26359
follows:26360

       (a) The department shall provide each provider or applicant 26361
information about accessing and completing the form prescribed 26362
pursuant to division (C)(1) of section 109.572 of the Revised Code 26363
and the standard fingerprint impression sheet prescribed pursuant 26364
to division (C)(2) of that section.26365

       (b) The provider or applicant shall submit the required form 26366
and one complete set of fingerprint impressions directly to the 26367
superintendent for purposes of conducting the criminal records 26368
check using the applicable methods prescribed by division (C) of 26369
section 109.572 of the Revised Code. The applicant or provider 26370
shall pay all fees associated with obtaining the criminal records 26371
check.26372

       (c) The superintendent shall conduct the criminal records 26373
check in accordance with section 109.572 of the Revised Code. The 26374
provider or applicant shall instruct the superintendent to submit 26375
the report of the criminal records check directly to the director 26376
of job and family services.26377

       (2) Criminal records checks required under this section for 26378
persons specified by the department under division (C)(1) of this 26379
section shall be obtained as follows:26380

       (a) The provider shall give to each person subject to 26381
criminal records check requirement information about accessing and 26382
completing the form prescribed pursuant to division (C)(1) of 26383
section 109.572 of the Revised Code and the standard fingerprint 26384
impression sheet prescribed pursuant to division (C)(2) of that 26385
section.26386

       (b) The person shall submit the required form and one 26387
complete set of fingerprint impressions directly to the 26388
superintendent for purposes of conducting the criminal records 26389
check using the applicable methods prescribed by division (C) of 26390
section 109.572 of the Revised Code. The person shall pay all fees 26391
associated with obtaining the criminal records check.26392

       (c) The superintendent shall conduct the criminal records 26393
check in accordance with section 109.572 of the Revised Code. The 26394
person subject to the criminal records check shall instruct the 26395
superintendent to submit the report of the criminal records check 26396
directly to the provider. The department may require the provider 26397
to submit the report to the department.26398

       (F) If a provider or applicant to be a provider is given the 26399
information specified in division (E)(1)(a) of this section but 26400
fails to obtain a criminal records check, the department shall, as 26401
applicable, terminate the provider agreement or deny the 26402
application to be a provider.26403

       If a person is given the information specified in division 26404
(E)(2)(a) of this section but fails to obtain a criminal records 26405
check, the provider shall not, as applicable, permit the person to 26406
be an employee, owner, officer, or board member of the provider.26407

       (G) Except as provided in rules adopted under division (J) of 26408
this section, the department shall terminate the provider 26409
agreement of a provider or the department shall not issue a 26410
provider agreement to an applicant if the provider or applicant is 26411
subject to a criminal records check under this section and the 26412
provider or applicant has been convicted of, has pleaded guilty 26413
to, or has been found eligible for intervention in lieu of 26414
conviction for any of the following:26415

       (1) A violation of section 2903.01, 2903.02, 2903.03, 26416
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 26417
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02, 26418
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 26419
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32, 26420
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 26421
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 26422
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11, 26423
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02, 26424
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04, 26425
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or 26426
3716.11 of the Revised Code, felonious sexual penetration in 26427
violation of former section 2907.12 of the Revised Code, a 26428
violation of section 2905.04 of the Revised Code as it existed 26429
prior to July 1, 1996, a violation of section 2919.23 of the 26430
Revised Code that would have been a violation of section 2905.04 26431
of the Revised Code as it existed prior to July 1, 1996, had the 26432
violation been committed prior to that date;26433

       (2) An existing or former law of this state, any other state, 26434
or the United States that is substantially equivalent to any of 26435
the offenses listed in division (G)(1) of this section.26436

       (H)(1)(a) Except as provided in rules adopted under division 26437
(J) of this section and subject to division (H)(2) of this 26438
section, no provider shall permit a person to be an employee, 26439
owner, officer, or board member of the provider if the person is 26440
subject to a criminal records check under this section and the 26441
person has been convicted of, has pleaded guilty to, or has been 26442
found eligible for intervention in lieu of conviction for any of 26443
the offenses specified in division (G)(1) or (2) of this section.26444

       (b) No provider shall employ a person who has been excluded 26445
from participating in the medicaid program, the medicare program 26446
operated pursuant to Title XVIII of the "Social Security Act," or 26447
any other federal health care program.26448

       (2)(a) A provider may employ conditionally a person for whom 26449
a criminal records check is required under this section prior to 26450
obtaining the results of a criminal records check regarding the 26451
person, but only if the person submits a request for a criminal 26452
records check not later than five business days after the 26453
individual begins conditional employment.26454

       (b) A provider that employs a person conditionally under 26455
authority of division (H)(2)(a) of this section shall terminate 26456
the person's employment if the results of the criminal records 26457
check request are not obtained within the period ending sixty days 26458
after the date the request is made. Regardless of when the results 26459
of the criminal records check are obtained, if the results 26460
indicate that the individual has been convicted of, has pleaded 26461
guilty to, or has been found eligible for intervention in lieu of 26462
conviction for any of the offenses specified in division (G)(1) or 26463
(2) of this section, the provider shall terminate the person's 26464
employment unless the provider chooses to employ the individual 26465
pursuant to division (J) of this section.26466

       (I) The report of a criminal records check conducted pursuant 26467
to this section is not a public record for the purposes of section 26468
149.43 of the Revised Code and shall not be made available to any 26469
person other than the following:26470

       (1) The person who is the subject of the criminal records 26471
check or the person's representative;26472

       (2) The director of job and family serviceshealth care 26473
administration and the staff of the department in the 26474
administration of the medicaid program;26475

       (3) A court, hearing officer, or other necessary individual 26476
involved in a case dealing with the denial or termination of a 26477
provider agreement;26478

       (4) A court, hearing officer, or other necessary individual 26479
involved in a case dealing with a person's denial of employment, 26480
termination of employment, or employment or unemployment benefits.26481

       (J) The department may adopt rules in accordance with Chapter 26482
119. of the Revised Code to implement this section. The rules may 26483
specify circumstances under which the department may continue a 26484
provider agreement or issue a provider agreement to an applicant 26485
when the provider or applicant has been convicted of, has pleaded 26486
guilty to, or has been found eligible for intervention in lieu of 26487
conviction for any of the offenses specified in division (G)(1) or 26488
(2) of this section. The rules may also specify circumstances 26489
under which a provider may permit a person to be an employee, 26490
owner, officer, or board member of the provider, when the person 26491
has been convicted of, has pleaded guilty to, or has been found 26492
eligible for intervention in lieu of conviction for any of the 26493
offenses specified in division (G)(1) or (2) of this section.26494

       Sec. 5111.033.        Sec. 5163.033.  (A) As used in this section:26495

       (1) "Applicant" means a person who is under final 26496
consideration for employment or, after September 26, 2003, an 26497
existing employee with a waiver agency in a full-time, part-time, 26498
or temporary position that involves providing home and 26499
community-based waiver services to a person with disabilities. 26500
"Applicant" also means an existing employee with a waiver agency 26501
in a full-time, part-time, or temporary position that involves 26502
providing home and community-based waiver services to a person 26503
with disabilities after September 26, 2003.26504

       (2) "Criminal records check" has the same meaning as in 26505
section 109.572 of the Revised Code.26506

       (3) "Waiver agency" means a person or government entity that 26507
is not certified under the medicare program and is accredited by 26508
the community health accreditation program or the joint commission 26509
on accreditation of health care organizations or a company that 26510
provides home and community-based waiver services to persons with 26511
disabilities through department of job and family serviceshealth 26512
care administration administered home and community-based waiver 26513
programs.26514

       (4) "Home and community-based waiver services" means services 26515
furnished under the provision of 42 C.F.R. 441, subpart G, that 26516
permit individuals to live in a home setting rather than a nursing 26517
facility or hospital. Home and community-based waiver services are 26518
approved by the centers for medicare and medicaid for specific 26519
populations and are not otherwise available under the medicaid 26520
state plan.26521

       (B)(1) The chief administrator of a waiver agency shall 26522
require each applicant to request that the superintendent of the 26523
bureau of criminal identification and investigation conduct a 26524
criminal records check with respect to the applicant. If an 26525
applicant for whom a criminal records check request is required 26526
under this division does not present proof of having been a 26527
resident of this state for the five-year period immediately prior 26528
to the date the criminal records check is requested or provide 26529
evidence that within that five-year period the superintendent has 26530
requested information about the applicant from the federal bureau 26531
of investigation in a criminal records check, the chief 26532
administrator shall require the applicant to request that the 26533
superintendent obtain information from the federal bureau of 26534
investigation as part of the criminal records check of the 26535
applicant. Even if an applicant for whom a criminal records check 26536
request is required under this division presents proof of having 26537
been a resident of this state for the five-year period, the chief 26538
administrator may require the applicant to request that the 26539
superintendent include information from the federal bureau of 26540
investigation in the criminal records check.26541

       (2) The chief administrator shall provide the following to 26542
each applicant for whom a criminal records check request is 26543
required under division (B)(1) of this section:26544

       (a) Information about accessing, completing, and forwarding 26545
to the superintendent of the bureau of criminal identification and 26546
investigation the form prescribed pursuant to division (C)(1) of 26547
section 109.572 of the Revised Code and the standard fingerprint 26548
impression sheet prescribed pursuant to division (C)(2) of that 26549
section;26550

       (b) Written notification that the applicant is to instruct 26551
the superintendent to submit the completed report of the criminal 26552
records check directly to the chief administrator.26553

       (3) An applicant given information and notification under 26554
divisions (B)(2)(a) and (b) of this section who fails to access, 26555
complete, and forward to the superintendent the form or the 26556
standard fingerprint impression sheet, or who fails to instruct 26557
the superintendent to submit the completed report of the criminal 26558
records check directly to the chief administrator, shall not be 26559
employed in any position in a waiver agency for which a criminal 26560
records check is required by this section.26561

       (C)(1) Except as provided in rules adopted by the department 26562
of job and family serviceshealth care administration in 26563
accordance with division (F) of this section and subject to 26564
division (C)(2) of this section, no waiver agency shall employ a 26565
person in a position that involves providing home and 26566
community-based waiver services to persons with disabilities if 26567
the person has been convicted of, has pleaded guilty to, or has 26568
been found eligible for intervention in lieu of conviction for 26569
any of the following:26570

       (a) A violation of section 2903.01, 2903.02, 2903.03, 26571
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 26572
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02, 26573
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 26574
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32, 26575
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 26576
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 26577
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11, 26578
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02, 26579
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04, 26580
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or 26581
3716.11 of the Revised Code, felonious sexual penetration in 26582
violation of former section 2907.12 of the Revised Code, a 26583
violation of section 2905.04 of the Revised Code as it existed 26584
prior to July 1, 1996, a violation of section 2919.23 of the 26585
Revised Code that would have been a violation of section 2905.04 26586
of the Revised Code as it existed prior to July 1, 1996, had the 26587
violation been committed prior to that date;26588

       (b) An existing or former law of this state, any other state, 26589
or the United States that is substantially equivalent to any of 26590
the offenses listed in division (C)(1)(a) of this section.26591

       (2)(a) A waiver agency may employ conditionally an applicant 26592
for whom a criminal records check request is required under 26593
division (B) of this section prior to obtaining the results of a 26594
criminal records check regarding the individual, provided that the 26595
agency shall require the individual to request a criminal records 26596
check regarding the individual in accordance with division (B)(1) 26597
of this section not later than five business days after the 26598
individual begins conditional employment.26599

       (b) A waiver agency that employs an individual conditionally 26600
under authority of division (C)(2)(a) of this section shall 26601
terminate the individual's employment if the results of the 26602
criminal records check request under division (B) of this section, 26603
other than the results of any request for information from the 26604
federal bureau of investigation, are not obtained within the 26605
period ending sixty days after the date the request is made. 26606
Regardless of when the results of the criminal records check are 26607
obtained, if the results indicate that the individual has been 26608
convicted of, has pleaded guilty to, or has been found eligible 26609
for intervention in lieu of conviction for any of the offenses 26610
listed or described in division (C)(1) of this section, the agency 26611
shall terminate the individual's employment unless the agency 26612
chooses to employ the individual pursuant to division (F) of this 26613
section.26614

       (D)(1) The fee prescribed pursuant to division (C)(3) of 26615
section 109.572 of the Revised Code for each criminal records 26616
check conducted pursuant to a request made under division (B) of 26617
this section shall be paid to the bureau of criminal 26618
identification and investigation by the applicant or the waiver 26619
agency.26620

       (2) If a waiver agency pays the fee, it may charge the 26621
applicant a fee not exceeding the amount the agency pays under 26622
division (D)(1) of this section. An agency may collect a fee only 26623
if the agency notifies the person at the time of initial 26624
application for employment of the amount of the fee and that, 26625
unless the fee is paid, the person will not be considered for 26626
employment.26627

       (E) The report of any criminal records check conducted 26628
pursuant to a request made under this section is not a public 26629
record for the purposes of section 149.43 of the Revised Code and 26630
shall not be made available to any person other than the 26631
following:26632

       (1) The individual who is the subject of the criminal records 26633
check or the individual's representative;26634

       (2) The chief administrator of the agency requesting the 26635
criminal records check or the administrator's representative;26636

       (3) An administrator at the department;26637

       (4) A court, hearing officer, or other necessary individual 26638
involved in a case dealing with a denial of employment of the 26639
applicant or dealing with employment or unemployment benefits of 26640
the applicant.26641

       (F) The department shall adopt rules in accordance with 26642
Chapter 119. of the Revised Code to implement this section. The 26643
rules shall specify circumstances under which a waiver agency may 26644
employ a person who has been convicted of, has pleaded guilty to, 26645
or has been found eligible for intervention in lieu of conviction 26646
for an offense listed or described in division (C)(1) of this 26647
section.26648

       (G) The chief administrator of a waiver agency shall inform 26649
each person, at the time of initial application for a position 26650
that involves providing home and community-based waiver services 26651
to a person with a disability, that the person is required to 26652
provide a set of fingerprint impressions and that a criminal 26653
records check is required to be conducted if the person comes 26654
under final consideration for employment.26655

       (H)(1) A person who, on September 26, 2003, is an employee 26656
of a waiver agency in a full-time, part-time, or temporary 26657
position that involves providing home and community-based waiver 26658
services to a person with disabilities shall comply with this 26659
section within sixty days after September 26, 2003, unless 26660
division (H)(2) of this section applies.26661

       (2) This section shall not apply to a person to whom all of 26662
the following apply:26663

       (a) On September 26, 2003, the person is an employee of a 26664
waiver agency in a full-time, part-time, or temporary position 26665
that involves providing home and community-based waiver services 26666
to a person with disabilities.26667

       (b) The person previously had been the subject of a criminal 26668
background check relating to that position; 26669

       (c) The person has been continuously employed in that 26670
position since that criminal background check had been conducted.26671

       Sec. 5111.034.        Sec. 5163.034.  (A) As used in this section:26672

       (1) "Anniversary date" means the later of the effective date 26673
of the provider agreement relating to the independent provider or 26674
sixty days after September 26, 2003.26675

       (2) "Criminal records check" has the same meaning as in 26676
section 109.572 of the Revised Code.26677

       (3) "Department" includes a designee of the department of 26678
job and family serviceshealth care administration.26679

       (4) "Independent provider" means a person who is submitting 26680
an application for a provider agreement or who has a provider 26681
agreement as an independent provider in a department of job and 26682
family serviceshealth care administration administered home and 26683
community-based services program providing home and 26684
community-based waiver services to consumers with disabilities.26685

       (5) "Home and community-based waiver services" has the same 26686
meaning as in section 5111.0335163.033 of the Revised Code.26687

       (B)(1) The department of job and family serviceshealth care 26688
administration shall inform each independent provider, at the 26689
time of initial application for a provider agreement that 26690
involves providing home and community-based waiver services to 26691
consumers with disabilities, that the independent provider is 26692
required to provide a set of fingerprint impressions and that a 26693
criminal records check is required to be conducted if the person 26694
is to become an independent provider in a department administered 26695
home and community-based waiver program.26696

       (2) Beginning on September 26, 2003, the department shall 26697
inform each enrolled medicaid independent provider on or before 26698
time of the anniversary date of the provider agreement that 26699
involves providing home and community-based waiver services to 26700
consumers with disabilities that the independent provider is 26701
required to provide a set of fingerprint impressions and that a 26702
criminal records check is required to be conducted.26703

       (C)(1) The department shall require the independent provider 26704
to complete a criminal records check prior to entering into a 26705
provider agreement with the independent provider and at least 26706
annually thereafter. If an independent provider for whom a 26707
criminal records check is required under this division does not 26708
present proof of having been a resident of this state for the 26709
five-year period immediately prior to the date the criminal 26710
records check is requested or provide evidence that within that 26711
five-year period the superintendent of the bureau of criminal 26712
identification and investigation has requested information about 26713
the independent provider from the federal bureau of investigation 26714
in a criminal records check, the department shall request that 26715
the independent provider obtain through the superintendent a 26716
criminal records request from the federal bureau of investigation 26717
as part of the criminal records check of the independent 26718
provider. Even if an independent provider for whom a criminal 26719
records check request is required under this division presents 26720
proof of having been a resident of this state for the five-year 26721
period, the department may request that the independent provider 26722
obtain information through the superintendent from the federal 26723
bureau of investigation in the criminal records check.26724

       (2) The department shall provide the following to each 26725
independent provider for whom a criminal records check request 26726
is required under division (C)(1) of this section:26727

       (a) Information about accessing, completing, and forwarding 26728
to the superintendent of the bureau of criminal identification and 26729
investigation the form prescribed pursuant to division (C)(1) of 26730
section 109.572 of the Revised Code and the standard fingerprint 26731
impression sheet prescribed pursuant to division (C)(2) of that 26732
section;26733

       (b) Written notification that the independent provider is to 26734
instruct the superintendent to submit the completed report of the 26735
criminal records check directly to the department.26736

       (3) An independent provider given information and 26737
notification under divisions (C)(2)(a) and (b) of this section 26738
who fails to access, complete, and forward to the superintendent 26739
the form or the standard fingerprint impression sheet, or who 26740
fails to instruct the superintendent to submit the completed 26741
report of the criminal records check directly to the department, 26742
shall not be approved as an independent provider.26743

       (D) Except as provided in rules adopted by the department in 26744
accordance with division (G) of this section, the department shall 26745
not issue a new provider agreement to, and shall terminate an 26746
existing provider agreement of, an independent provider if the 26747
person has been convicted of, has pleaded guilty to, or has been 26748
found eligible for intervention in lieu of conviction for any of 26749
the following:26750

       (1) A violation of section 2903.01, 2903.02, 2903.03, 26751
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 26752
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02, 26753
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 26754
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32, 26755
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 26756
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 26757
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11, 26758
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02, 26759
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04, 26760
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or 26761
3716.11 of the Revised Code, felonious sexual penetration in 26762
violation of former section 2907.12 of the Revised Code, a 26763
violation of section 2905.04 of the Revised Code as it existed 26764
prior to July 1, 1996, a violation of section 2919.23 of the 26765
Revised Code that would have been a violation of section 2905.04 26766
of the Revised Code as it existed prior to July 1, 1996, had the 26767
violation been committed prior to that date;26768

       (2) An existing or former law of this state, any other state, 26769
or the United States that is substantially equivalent to any of 26770
the offenses listed in division (D)(1) of this section.26771

       (E) Each independent provider shall pay to the bureau of 26772
criminal identification and investigation the fee prescribed 26773
pursuant to division (C)(3) of section 109.572 of the Revised Code 26774
for each criminal records check conducted pursuant to a request 26775
made under division (C) of this section.26776

       (F) The report of any criminal records check conducted by the 26777
bureau of criminal identification and investigation in accordance 26778
with section 109.572 of the Revised Code and pursuant to a request 26779
made under division (C) of this section is not a public record for 26780
the purposes of section 149.43 of the Revised Code and shall not 26781
be made available to any person other than the following:26782

       (1) The person who is the subject of the criminal records 26783
check or the person's representative;26784

       (2) An administrator at the department or the administrator's 26785
representative;26786

       (3) A court, hearing officer, or other necessary individual 26787
involved in a case dealing with a denial or termination of a 26788
provider agreement related to the criminal records check.26789

       (G) The department shall adopt rules in accordance with 26790
Chapter 119. of the Revised Code to implement this section. The 26791
rules shall specify circumstances under which the department may 26792
either issue a provider agreement to an independent provider or 26793
allow an independent provider to maintain an existing provider 26794
agreement when the independent provider has been convicted of, 26795
has pleaded guilty to, or has been found eligible for intervention 26796
in lieu of conviction for an offense listed or described in 26797
division (C)(1) of this section.26798

       Sec. 5163.04.  The department of health care administration 26799
may conduct final fiscal audits under the medicaid program in 26800
accordance with the applicable requirements set forth in federal 26801
laws and regulations and determine any amounts the provider may 26802
owe the state. When conducting final fiscal audits, the department 26803
shall consider generally accepted auditing standards, which 26804
include the use of statistical sampling.26805

       Sec. 5111.914.        Sec. 5163.06. (A) As used in this section, 26806
"provider" has the same meaning as in section 5111.065163.01 of 26807
the Revised Code.26808

       (B) If a state agency that enters into a contract with the 26809
department of job and family serviceshealth care administration26810
under section 5111.915161.05 of the Revised Code identifies that 26811
a medicaid overpayment has been made to a provider, the state 26812
agency may commence actions to recover the overpayment on behalf 26813
of the department.26814

       (C) In recovering an overpayment pursuant to this section, a 26815
state agency shall comply with the following procedures:26816

       (1) The state agency shall attempt to recover the overpayment 26817
by notifying the provider of the overpayment and requesting 26818
voluntary repayment. Not later than five business days after 26819
notifying the provider, the state agency shall notify the 26820
department in writing of the overpayment. The state agency may 26821
negotiate a settlement of the overpayment and notify the 26822
department of the settlement. A settlement negotiated by the state 26823
agency is not valid and shall not be implemented until the 26824
department has given its written approval of the settlement.26825

       (2) If the state agency is unable to obtain voluntary 26826
repayment of an overpayment, the agency shall give the provider 26827
notice of an opportunity for a hearing in accordance with Chapter 26828
119. of the Revised Code. If the provider timely requests a 26829
hearing in accordance with section 119.07 of the Revised Code, the 26830
state agency shall conduct the hearing to determine the legal and 26831
factual validity of the overpayment. On completion of the hearing, 26832
the state agency shall submit its hearing officer's report and 26833
recommendation and the complete record of proceedings, including 26834
all transcripts, to the director of job and family serviceshealth 26835
care administration for final adjudication. The director may issue 26836
a final adjudication order in accordance with Chapter 119. of the 26837
Revised Code. The state agency shall pay any attorney's fees 26838
imposed under section 119.092 of the Revised Code. The department 26839
of job and family services shall pay any attorney's fees imposed 26840
under section 2335.39 of the Revised Code.26841

       (D) In any action taken by a state agency under this section 26842
that requires the agency to give notice of an opportunity for a 26843
hearing in accordance with Chapter 119. of the Revised Code, if 26844
the agency gives notice of the opportunity for a hearing but the 26845
provider subject to the notice does not request a hearing or 26846
timely request a hearing in accordance with section 119.07 of the 26847
Revised Code, the agency is not required to hold a hearing. The 26848
agency may request that the director of job and family services26849
health care administration issue a final adjudication order in 26850
accordance with Chapter 119. of the Revised Code.26851

       (E) This section does not preclude the department of job and 26852
family serviceshealth care administration from adjudicating a 26853
final fiscal audit under section 5111.065163.01 of the Revised 26854
Code, recovering overpayments under section 5111.0615163.07 of 26855
the Revised Code, or making findings or taking other actions 26856
authorized by this chapter.26857

       Sec. 5111.061.        Sec. 5163.07. (A) The department of job and family 26858
serviceshealth care administration may recover a medicaid payment 26859
or portion of a payment made to a provider to which the provider 26860
is not entitled if the department notifies the provider of the 26861
overpayment during the five-year period immediately following the 26862
end of the state fiscal year in which the overpayment was made.26863

       (B) Among the overpayments that may be recovered under this 26864
section are the following:26865

       (1) Payment for a service, or a day of service, not rendered;26866

       (2) Payment for a day of service at a full per diem rate that 26867
should have been paid at a percentage of the full per diem rate;26868

       (3) Payment for a service, or day of service, that was paid 26869
by, or partially paid by, a third-party, as defined in section 26870
5101.5715160.36 of the Revised Code, and the third-party's 26871
payment or partial payment was not offset against the amount paid 26872
by the medicaid program to reduce or eliminate the amount that was 26873
paid by the medicaid program;26874

       (4) Payment when a medicaid recipient's responsibility for 26875
payment was understated and resulted in an overpayment to the 26876
provider.26877

       (C) The department may recover an overpayment under this 26878
section prior to or after any of the following:26879

       (1) Adjudication of a final fiscal audit that section 5111.0626880
5163.01 of the Revised Code requires to be conducted in accordance 26881
with Chapter 119. of the Revised Code;26882

       (2) Adjudication of a finding under any other provision of 26883
this chapter or the rules adopted under it;26884

       (3) Expiration of the time to issue a final fiscal audit that 26885
section 5111.065163.01 of the Revised Code requires to be 26886
conducted in accordance with Chapter 119. of the Revised Code;26887

       (4) Expiration of the time to issue a finding under any other 26888
provision of this chapter or the rules adopted under it.26889

       (D)(1) Subject to division (D)(2) of this section, the 26890
recovery of an overpayment under this section does not preclude 26891
the department from subsequently doing the following:26892

       (a) Issuing a final fiscal audit in accordance with Chapter 26893
119. of the Revised Code, as required under section 5111.0626894
5163.01 of the Revised Code;26895

       (b) Issuing a finding under any other provision of this 26896
chapter or the rules adopted under it.26897

       (2) A final fiscal audit or finding issued subsequent to the 26898
recovery of an overpayment under this section shall be reduced by 26899
the amount of the prior recovery, as appropriate.26900

       (E) Nothing in this section limits the department's authority 26901
to recover overpayments pursuant to any other provision of the 26902
Revised Code.26903

       Sec. 5111.022.        Sec. 5163.08.  Under the medicaid program, any26904
amount determined to be owed the state by a final fiscal audit26905
conducted pursuant to division (D) of section 5111.0215163.04 of 26906
the Revised Code, upon the issuance of an adjudication order 26907
pursuant to Chapter 119. of the Revised Code that contains a 26908
finding that there is a preponderance of the evidence that the 26909
provider will liquidate assets or file bankruptcy in order to 26910
prevent payment of the amount determined to be owed the state, 26911
becomes a lien upon the real and personal property of the 26912
provider. Upon failure of the provider to pay the amount to the 26913
state, the director of job and family serviceshealth care 26914
administration shall file notice of the lien, for which there 26915
shall be no charge, in the office of the county recorder of the 26916
county in which it is ascertained that the provider owns real or 26917
personal property. The director shall notify the provider by mail 26918
of the lien, but absence of proof that the notice was sent does 26919
not affect the validity of the lien. The lien is not valid as 26920
against the claim of any mortgagee, pledgee, purchaser, judgment 26921
creditor, or other lienholder of record at the time the notice is 26922
filed.26923

       If the provider acquires real or personal property after26924
notice of the lien is filed, the lien shall not be valid as26925
against the claim of any mortgagee, pledgee, subsequent bona fide26926
purchaser for value, judgment creditor, or other lienholder of26927
record to such after-acquired property unless the notice of lien26928
is refiled after the property is acquired by the provider and26929
before the competing lien attaches to the after-acquired property26930
or before the conveyance to the subsequent bona fide purchaser for 26931
value.26932

       When the amount has been paid, the provider may record with26933
the recorder notice of the payment. For recording such notice of26934
payment, the recorder shall charge and receive from the provider a 26935
base fee of one dollar for services and a housing trust fund fee 26936
of one dollar pursuant to section 317.36 of the Revised Code.26937

       In the event of a distribution of a provider's assets26938
pursuant to an order of any court under the law of this state26939
including any receivership, assignment for benefit of creditors,26940
adjudicated insolvency, or similar proceedings, amounts then or26941
thereafter due the state under this chapter have the same priority 26942
as provided by law for the payment of taxes due the state and 26943
shall be paid out of the receivership trust fund or other such 26944
trust fund in the same manner as provided for claims for unpaid 26945
taxes due the state.26946

       If the attorney general finds after investigation that any26947
amount due the state under this chapter is uncollectable, in whole 26948
or in part, the attorney general shall recommend to the director 26949
the cancellation of all or part of the claim. The director may26950
thereupon effect the cancellation.26951

       Sec. 5111.062.        Sec. 5163.09. In any action taken by the department 26952
of job and family serviceshealth care administration under 26953
section 5111.065163.01 or 5111.0615163.07 of the Revised Code 26954
or any other provision of this chapterlaw governing the medicaid 26955
program that requires the department to give notice of an 26956
opportunity for a hearing in accordance with Chapter 119. of the 26957
Revised Code, if the department gives notice of the opportunity 26958
for a hearing but the provider or other entity subject to the 26959
notice does not request a hearing or timely request a hearing in 26960
accordance with section 119.07 of the Revised Code, the 26961
department is not required to hold a hearing. The director of job 26962
and family servicehealth care administration may proceed by 26963
issuing a final adjudication order in accordance with Chapter 119. 26964
of the Revised Code.26965

       Sec. 5111.101.        Sec. 5163.12. (A) As used in this section;26966

        "Agent" and "contractor" include any agent, contractor, 26967
subcontractor, or other person who, on behalf of an entity, 26968
furnishes or authorizes the furnishing of health care items or 26969
services under the medicaid program, performs billing or coding 26970
functions, or is involved in monitoring of health care that an 26971
entity provides.26972

       "Employee" includes any officer or employee (including 26973
management employees) of an entity.26974

       "Entity" includes a governmental entity or an organization, 26975
unit, corporation, partnership, or other business arrangement, 26976
including any medicaid managed care organization, irrespective of 26977
the form of business structure or arrangement by which it exists, 26978
whether for-profit or not-for-profit. "Entity" does not include a 26979
government entity that administers one or more components of the 26980
medicaid program, unless the government entity receives medicaid 26981
payments for providing items or services.26982

       "Federal health care programs" has the same meaning as in 42 26983
U.S.C. 1320a-7b(f).26984

       (B) Each entity that receives or makes in a federal fiscal 26985
year payments under the medicaid program, either through the state 26986
medicaid plan or a federal medicaid waiver, totaling at least five 26987
million dollars shall, as a condition of receiving such payments, 26988
do all of the following not later than the first day of the 26989
succeeding calendar year:26990

       (1) Establish written policies for all of the entity's 26991
employees, contractors, and agents that provide detailed 26992
information about the role of all of the following in preventing 26993
and detecting fraud, waste, and abuse in federal health care 26994
programs:26995

       (a) Federal false claims law under 31 U.S.C. 3729 to 3733;26996

       (b) Federal administrative remedies for false claims and 26997
statements available under 31 U.S.C. 3801 to 3812;26998

       (c) Sections 124.341, 2913.40, 2913.401, and 2921.13 of the 26999
Revised Code and any other state laws pertaining to civil or 27000
criminal penalties for false claims and statements;27001

       (d) Whistleblower protections under the laws specified in 27002
divisions (B)(1)(a) to (c) of this section.27003

       (2) Include as part of the written policies required by 27004
division (B)(1) of this section detailed provisions regarding the 27005
entity's policies and procedures for preventing and detecting 27006
fraud, waste, and abuse.27007

       (3) Disseminate the written policies required by division 27008
(B)(1) of this section to each of the entity's employees, 27009
contractors, and agents in a paper or electronic form and make the 27010
written policies readily available to the entity's employees, 27011
contractors, and agents.27012

       (4) If the entity has an employee handbook, include in the 27013
employee handbook a specific discussion of the laws specified in 27014
division (B)(1) of this section, the rights of employees to be 27015
protected as whistleblowers, and the entity's policies and 27016
procedures for preventing and detecting fraud, waste, and abuse.27017

       (5) Require the entity's contractors and agents to adopt the 27018
entity's written policies required by division (B)(1) of this 27019
section.27020

       (C) An entity that furnishes items or services at multiple 27021
locations or under multiple contractual or other payment 27022
arrangements is required to comply with division (B) of this 27023
section if the entity receives in a federal fiscal year medicaid 27024
payments totaling in the aggregate at least five million dollars. 27025
This applies regardless of whether the entity submits claims for 27026
medicaid payments using multiple provider identification or tax 27027
identification numbers.27028

       Sec. 5111.02.        Sec. 5163.15. The director of job and family services27029
health care administration shall adopt, and may amend or rescind, 27030
rules under Chapter 119. of the Revised Code establishing the 27031
amount, duration, and scope of medicaid services. The rules shall 27032
be consistent with federal and state law. The rules may be 27033
different for different medicaid services. The rules shall 27034
establish all of the following:27035

        (A) The conditions under which the medicaid program shall 27036
cover and reimburse medicaid services;27037

        (B) The method of reimbursement applicable to each medicaid 27038
service;27039

        (C) The amount of reimbursement or, in lieu of amounts, 27040
methods by which amounts are to be determined for each medicaid 27041
service;27042

        (D) Procedures for enforcing the rules adopted under this 27043
section that provide due process protections, including procedures 27044
for corrective action plans for, and imposing financial and 27045
administrative sanctions on, persons and government entities that 27046
violate the rules.27047

       Sec. 5111.021.        Sec. 5163.16.  Under the medicaid program:27048

       (A) Except as otherwise permitted by federal statute or27049
regulation and at the department's discretion, reimbursement by27050
the department of job and family serviceshealth care 27051
administration to a medical provider for any medical service 27052
rendered under the program shall not exceed the authorized 27053
reimbursement level for the same service under the medicare 27054
program established under Title XVIII of the "Social Security 27055
Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended.27056

       (B) Reimbursement for freestanding medical laboratory charges 27057
shall not exceed the customary and usual fee for laboratory 27058
profiles.27059

       (C) The department may deduct from payments for services27060
rendered by a medicaid provider under the medicaid program any 27061
amounts the provider owes the state as the result of incorrect 27062
medicaid payments the department has made to the provider.27063

       (D) The department may conduct final fiscal audits in27064
accordance with the applicable requirements set forth in federal27065
laws and regulations and determine any amounts the provider may27066
owe the state. When conducting final fiscal audits, the department 27067
shall consider generally accepted auditing standards, which 27068
include the use of statistical sampling.27069

       (E) The number of days of inpatient hospital care for which27070
reimbursement is made on behalf of a medicaid recipient to a 27071
hospital that is not paid under a diagnostic-related-group 27072
prospective payment system shall not exceed thirty days during a 27073
period beginning on the day of the recipient's admission to the 27074
hospital and ending sixty days after the termination of that 27075
hospital stay, except that the department may make exceptions to 27076
this limitation. The limitation does not apply to children 27077
participating in the program for medically handicapped children 27078
established under section 3701.023 of the Revised Code.27079

       (F)(E) The division of any reimbursement between a27080
collaborating physician or podiatrist and a clinical nurse27081
specialist, certified nurse-midwife, or certified nurse27082
practitioner for services performed by the nurse shall be27083
determined and agreed on by the nurse and collaborating physician27084
or podiatrist. In no case shall reimbursement exceed the payment27085
that the physician or podiatrist would have received had the27086
physician or podiatrist provided the entire service.27087

       Sec. 5111.025.        Sec. 5163.17. (A) In rules adopted under section 27088
5111.025163.15 of the Revised Code, the director of job and 27089
family serviceshealth care administration shall modify the manner 27090
or establish a new manner in which the following are paid under 27091
medicaid:27092

        (1) Community mental health facilities for providing mental 27093
health services included in the state medicaid plan pursuant to 27094
section 5111.0235163.20 of the Revised Code;27095

        (2) Providers of alcohol and drug addiction services for 27096
providing alcohol and drug addiction services included in the 27097
medicaid program pursuant to rules adopted under section 5111.0227098
5163.15 of the Revised Code.27099

       (B) The director's authority to modify the manner, or to 27100
establish a new manner, for medicaid to pay for the services 27101
specified in division (A) of this section is not limited by any 27102
rules adopted under section 5111.025163.15 or 5119.61 of the 27103
Revised Code that are in effect on June 26, 2003, and govern the 27104
way medicaid pays for those services. This is the case regardless 27105
of what state agency adopted the rules.27106

       Sec. 5111.018.        Sec. 5163.18.  (A) The provision of medical 27107
assistance under this chaptermedicaid program shall include 27108
coverage ofcover inpatient care and follow-up care for a mother 27109
and her newborn as follows:27110

       (1) The medical assistancemedicaid program shall cover a 27111
minimum of forty-eight hours of inpatient care following a normal 27112
vaginal delivery and a minimum of ninety-six hours of inpatient 27113
care following a cesarean delivery. Services covered as inpatient 27114
care shall include medical, educational, and any other services 27115
that are consistent with the inpatient care recommended in the27116
protocols and guidelines developed by national organizations that27117
represent pediatric, obstetric, and nursing professionals.27118

       (2) The medical assistancemedicaid program shall cover a27119
physician-directed source of follow-up care. Services covered as27120
follow-up care shall include physical assessment of the mother and27121
newborn, parent education, assistance and training in breast or27122
bottle feeding, assessment of the home support system, performance27123
of any medically necessary and appropriate clinical tests, and any27124
other services that are consistent with the follow-up care27125
recommended in the protocols and guidelines developed by national27126
organizations that represent pediatric, obstetric, and nursing27127
professionals. The coverage shall apply to services provided in a27128
medical setting or through home health care visits. The coverage27129
shall apply to a home health care visit only if the health care27130
professional who conducts the visit is knowledgeable and27131
experienced in maternity and newborn care.27132

       When a decision is made in accordance with division (B) of27133
this section to discharge a mother or newborn prior to the27134
expiration of the applicable number of hours of inpatient care27135
required to be covered, the coverage of follow-up care shall apply27136
to all follow-up care that is provided within forty-eight hours27137
after discharge. When a mother or newborn receives at least the27138
number of hours of inpatient care required to be covered, the27139
coverage of follow-up care shall apply to follow-up care that is27140
determined to be medically necessary by the health care27141
professionals responsible for discharging the mother or newborn.27142

       (B) Any decision to shorten the length of inpatient stay to27143
less than that specified under division (A)(1) of this section27144
shall be made by the physician attending the mother or newborn,27145
except that if a nurse-midwife is attending the mother in27146
collaboration with a physician, the decision may be made by the27147
nurse-midwife. Decisions regarding early discharge shall be made27148
only after conferring with the mother or a person responsible for27149
the mother or newborn. For purposes of this division, a person27150
responsible for the mother or newborn may include a parent,27151
guardian, or any other person with authority to make medical27152
decisions for the mother or newborn.27153

       (C) The department of job and family serviceshealth care 27154
administration, in administering the medical assistancemedicaid27155
program, may not do either of the following:27156

       (1) Terminate the participation of a health care professional 27157
or health care facility as a provider under the program solely for 27158
making recommendations for inpatient or follow-up care for a 27159
particular mother or newborn that are consistent with the care 27160
required to be covered by this section;27161

       (2) Establish or offer monetary or other financial incentives 27162
for the purpose of encouraging a person to decline the inpatient 27163
or follow-up care required to be covered by this section.27164

       (D) This section does not do any of the following:27165

       (1) Require the medical assistancemedicaid program to cover27166
inpatient or follow-up care that is not received in accordance27167
with the program's terms pertaining to the health care27168
professionals and facilities from which an individual is27169
authorized to receive health care services.27170

       (2) Require a mother or newborn to stay in a hospital or27171
other inpatient setting for a fixed period of time following27172
delivery;27173

       (3) Require a child to be delivered in a hospital or other27174
inpatient setting;27175

       (4) Authorize a nurse-midwife to practice beyond the27176
authority to practice nurse-midwifery in accordance with Chapter27177
4723. of the Revised Code;27178

       (5) Establish minimum standards of medical diagnosis, care,27179
or treatment for inpatient or follow-up care for a mother or27180
newborn. A deviation from the care required to be covered under27181
this section shall not, on the basis of this section, give rise to27182
a medical claim or derivative medical claim, as those terms are27183
defined in section 2305.113 of the Revised Code.27184

       Sec. 5111.024.        Sec. 5163.19.  (A) As used in this section, 27185
"screening mammography" means a radiologic examination utilized to 27186
detect unsuspected breast cancer at an early stage in asymptomatic 27187
women and includes the x-ray examination of the breast using 27188
equipment that is dedicated specifically for mammography, 27189
including the x-ray tube, filter, compression device, screens, 27190
film, and cassettes, and that has an average radiation exposure 27191
delivery of less than one rad mid-breast. "Screening mammography" 27192
includes two views for each breast. The term also includes the 27193
professional interpretation of the film.27194

       "Screening mammography" does not include diagnostic 27195
mammography.27196

       (B) In addition to any other services required to be included 27197
in the program or for which federal approval is received, the 27198
medical assistanceThe medicaid program shall includecover both 27199
of the following if approval for use of federal funds is granted 27200
to the department by the federal agency responsible for 27201
distributing funds under Title XIX of the "Social Security Act," 27202
49 Stat. 620 (1935), 42 U.S.C.A. 301, as amendedfederal financial 27203
participation is available for them:27204

       (1) Effective July 1, 1993, screeningScreening mammography 27205
to detect the presence of breast cancer in adult women;27206

       (2) Effective January 1, 1993, cytologicCytologic screening 27207
for the presence of cervical cancer.27208

       (C) The service provided under division (B)(1) of this27209
section shall be provided in accordance with all of the following:27210

       (1) If a woman is at least thirty-five years of age but under 27211
forty years of age, one screening mammography;27212

       (2) If a woman is at least forty years of age but under fifty 27213
years of age, either of the following:27214

       (a) One screening mammography every two years;27215

       (b) If a licensed physician has determined that the woman has 27216
risk factors to breast cancer, one screening mammography every 27217
year.27218

       (3) If a woman is at least fifty years of age but under27219
sixty-five years of age, one screening mammography every year.27220

       (D) The service provided under division (B)(1) of this27221
section shall be provided only for screening mammographies that27222
are performed in a facility or mobile mammography screening unit27223
that is accredited under the American college of radiology 27224
mammography accreditation program or in a hospital as defined in 27225
section 3727.01 of the Revised Code.27226

       (E) The service provided under division (B)(2) of this27227
section shall be provided only for cytologic screenings that are27228
processed and interpreted in a laboratory certified by the college 27229
of American pathologists or in a hospital as defined in section 27230
3727.01 of the Revised Code.27231

       Sec. 5111.023.        Sec. 5163.20.  (A) As used in this section:27232

       (1) "Community mental health facility" means a community 27233
mental health facility that has a quality assurance program 27234
accredited by the joint commission on accreditation of healthcare 27235
organizations or is certified by the department of mental health 27236
or department of job and family serviceshealth care 27237
administration.27238

        (2) "Mental health professional" means a person qualified to 27239
work with mentally ill persons under the standards established by 27240
the director of mental health pursuant to section 5119.611 of the 27241
Revised Code.27242

        (B) The state medicaid plan shall include provision of the27243
following mental health services when provided by community mental 27244
health facilities:27245

       (1) Outpatient mental health services, including, but not27246
limited to, preventive, diagnostic, therapeutic, rehabilitative,27247
and palliative interventions rendered to individuals in an27248
individual or group setting by a mental health professional in27249
accordance with a plan of treatment appropriately established,27250
monitored, and reviewed;27251

       (2) Partial-hospitalization mental health services rendered 27252
by persons directly supervised by a mental health professional;27253

       (3) Unscheduled, emergency mental health services of a kind27254
ordinarily provided to persons in crisis when rendered by persons27255
supervised by a mental health professional;27256

       (4) Subject to receipt of federal approval, assertive 27257
community treatment and intensive home-based mental health 27258
services.27259

       (C) The comprehensive annual plan shall certify the27260
availability of sufficient unencumbered community mental health27261
state subsidy and local funds to match federal medicaid 27262
reimbursement funds earned by community mental health facilities. 27263

       (D) The department of job and family serviceshealth care 27264
administration shall enter into a separate contract with the 27265
department of mental health under section 5111.915161.05 of the 27266
Revised Code with regard to the component of the medicaid program 27267
provided for by this section.27268

       (E) Not later than July 21, 2006, the department of job and 27269
family serviceshealth care administration shall request federal 27270
approval to provide assertive community treatment and intensive 27271
home-based mental health services under medicaid pursuant to this 27272
section.27273

       (F) On receipt of federal approval sought under division (E) 27274
of this section, the director of job and family serviceshealth 27275
care administration shall adopt rules in accordance with Chapter 27276
119. of the Revised Code for assertive community treatment and 27277
intensive home-based mental health services provided under 27278
medicaid pursuant to this section. The director shall consult 27279
with the department of mental health in adopting the rules.27280

       Sec. 5111.04.        Sec. 5163.21.  (A) As used in this section:27281

       (1) "Outpatient health facility" means a facility that27282
provides comprehensive primary health services by or under the27283
direction of a physician at least five days per week on a27284
forty-hour per week basis to outpatients, is operated by the board27285
of health of a city or general health district or another public27286
agency or by a nonprofit private agency or organization under the27287
direction and control of a governing board that has no27288
health-related responsibilities other than the direction and27289
control of one or more such outpatient health facilities, and27290
receives at least seventy-five per cent of its operating funds27291
from public sources, except that it does not include an outpatient27292
hospital facility or a federally qualified health center as27293
defined in Sec. 1905(l) (2)(B) of the "Social Security Act," 10327294
Stat. 2264 (1989), 42 U.S.C.A. 1396d(l)(2)(B).27295

       (2) "Comprehensive primary health services" means preventive,27296
diagnostic, therapeutic, rehabilitative, or palliative items or27297
services that include all of the following:27298

       (a) Services of physicians, physician assistants, and27299
certified nurse practitioners;27300

       (b) Diagnostic laboratory and radiological services;27301

       (c) Preventive health services, such as children's eye and27302
ear examinations, perinatal services, well child services, and27303
family planning services;27304

       (d) Arrangements for emergency medical services;27305

       (e) Transportation services.27306

       (3) "Certified nurse practitioner" has the same meaning as in27307
section 4723.01 of the Revised Code.27308

       (B) Outpatient health facilities are a separate category of27309
medical care provider under the rules governing the administration27310
of the medical assistancemedicaid program established under 27311
section 5111.01 of the Revised Code. Rates of reimbursement for 27312
items and services provided by an outpatient health facility under 27313
this section shall be prospectively determined by the department 27314
of job and family serviceshealth care administration not less 27315
often than once each year, shall not be subject to retroactive27316
adjustment based on actual costs incurred, and shall not exceed27317
the maximum fee schedule or rates of payment, limitations based on 27318
reasonable costs or customary charges, and limitations based on 27319
combined payments received for furnishing comparable services, as 27320
are applicable to outpatient hospital facilities under Title XVIII 27321
of the "Social Security Actmedicare program." In determining 27322
rates of reimbursement prospectively, the department shall take 27323
into account the historic expenses of the facility, the operating27324
requirements and services offered by the facility, and the27325
geographical location of the facility, shall provide incentives27326
for the efficient and economical utilization of the facility's27327
resources, and shall ensure that the facility does not27328
discriminate between classes of persons for whom or by whom27329
payment for items and services is made.27330

       (C) A facility does not qualify for classification as an27331
outpatient health facility under this section unless it:27332

       (1) Has health and medical care policies developed with the27333
advice of and subject to review by an advisory committee of27334
professional personnel, including one or more physicians, one or27335
more dentists if dental care is provided, and one or more27336
registered nurses;27337

       (2) Has a medical director, a dental director, if dental care 27338
is provided, and a nursing director responsible for the execution 27339
of such policies, and has physicians, dentists, nursing, and 27340
ancillary staff appropriate to the scope of services provided;27341

       (3) Requires that the care of every patient be under the27342
supervision of a physician, provides for medical care in case of27343
emergency, has in effect a written agreement with one or more27344
hospitals and one or more other outpatient facilities, and has an27345
established system for the referral of patients to other resources27346
and a utilization review plan and program;27347

       (4) Maintains clinical records on all patients;27348

       (5) Provides nursing services and other therapeutic services27349
in compliance with applicable laws and rules and under the27350
supervision of a registered nurse, and has a registered nurse on27351
duty at all times when the facility is in operation;27352

       (6) Follows approved methods and procedures for the27353
dispensing and administration of drugs and biologicals;27354

       (7) Maintains the accounting and record-keeping system27355
required under federal laws and regulations for the determination27356
of reasonable and allowable costs.27357

       Sec. 5111.14.        Sec. 5163.22.  The department of job and family 27358
serviceshealth care administration may require county departments 27359
of job and family services to provide case management of 27360
nonemergency transportation services provided under the medical 27361
assistancemedicaid program. County departments shall provide the 27362
case management if required by the department in accordance with 27363
rules adopted by the director of job and family serviceshealth 27364
care administration.27365

       The department shall determine, for the purposes of claiming 27366
federal reimbursement under the medical assistancemedicaid27367
program, whether it will claim expenditures for nonemergency 27368
transportation services as administrative or program expenditures.27369

       Sec. 5111.19.        Sec. 5163.23.  The director of job and family 27370
serviceshealth care administration shall adopt rules governing 27371
the calculation and payment of graduate medical education costs 27372
associated with services rendered to medicaid recipients after 27373
June 30, 1994. Subject to section 5111.1915163.231 of the Revised 27374
Code, the rules shall provide for reimbursement of graduate 27375
medical education costs associated with services rendered to 27376
medicaid recipients, including recipients enrolled in a managed 27377
care organization under contract with the department under section 27378
5111.175165.05 of the Revised Code, that the department 27379
determines are allowable and reasonable.27380

       If the department requires a managed care organization to pay 27381
a provider for graduate medical education costs associated with 27382
the delivery of services to medicaid recipients enrolled in the 27383
organization, the department shall include in its payment to the 27384
organization an amount sufficient for the organization to pay such27385
costs. If the department does not include in its payments to the 27386
managed care organization amounts for graduate medical education 27387
costs of providers, all of the following apply:27388

       (A) Except as provided in section 5111.1915163.231 of the 27389
Revised Code, the department shall pay the provider for graduate27390
medical education costs associated with the delivery of services27391
to medicaid recipients enrolled in the organization;27392

       (B) No provider shall seek reimbursement from the 27393
organization for such costs;27394

       (C) The organization is not required to pay providers for27395
such costs.27396

       Sec. 5111.191.        Sec. 5163.231.  (A) Except as provided in division 27397
(B) of this section, the department of job and family services27398
health care administration may deny payment to a hospital for 27399
direct graduate medical education costs associated with the 27400
delivery of services to any medicaid recipient if the hospital 27401
refuses without good cause to contract with a managed care 27402
organization that serves participants in the care management 27403
system established under section 5111.165165.03 of the Revised 27404
Code who are required to be enrolled in a managed care 27405
organization and the managed care organization serves the area in 27406
which the hospital is located.27407

       (B) A hospital is not subject to division (A) of this section 27408
if all of the following are the case:27409

        (1) The hospital is located in a county in which participants 27410
in the care management system are required before January 1, 2006, 27411
to be enrolled in a medicaid managed care organization that is a 27412
health insuring corporation.27413

        (2) The hospital has entered into a contract before January 27414
1, 2006, with at least one health insuring corporation serving the 27415
participants specified in division (B)(1) of this section.27416

        (3) The hospital remains under contract with at least one 27417
health insuring corporation serving participants in the care 27418
management system who are required to be enrolled in a health 27419
insuring corporation.27420

       (C) The director of job and family serviceshealth care 27421
administration shall specify in the rules adopted under section 27422
5111.195163.231 of the Revised Code what constitutes good cause 27423
for a hospital to refuse to contract with a managed care 27424
organization.27425

       Sec. 5111.082.        Sec. 5163.24. (A) As used in this section:27426

        (1) "State maximum allowable cost" means the per unit amount 27427
the department of job and family serviceshealth care 27428
administration reimburses a terminal distributor of dangerous 27429
drugs for a prescription drug included in the state maximum 27430
allowable cost program established under division (B) of this 27431
section. "State maximum allowable cost" excludes dispensing fees 27432
and copayments, coinsurance, or other cost-sharing charges, if 27433
any.27434

        (2) "Terminal distributor of dangerous drugs" has the same 27435
meaning as in section 4729.01 of the Revised Code.27436

        (B) The director of job and family serviceshealth care 27437
administration shall establish a state maximum allowable cost 27438
program for purposes of managing reimbursement to terminal 27439
distributors of dangerous drugs for prescription drugs identified 27440
by the director pursuant to this division. The director shall do 27441
all of the following with respect to the program:27442

        (1) Identify and create a list of prescription drugs to be 27443
included in the program.27444

        (2) Update the list of prescription drugs described in 27445
division (B)(1) of this section on a weekly basis.27446

        (3) Review the state maximum allowable cost for each drug 27447
included on the list described in division (B)(1) of this section 27448
on a weekly basis.27449

        (C) The director may adopt rules in accordance with Chapter 27450
119. of the Revised Code to implement this section.27451

       Sec. 5111.08.        Sec. 5163.241.  In accordance with subsection (g) of 27452
section 1927 of the "Social Security Act," 49 Stat. 320 (1935), 42 27453
U.S.C.A. 1396r-8(g), as amended, the department of job and family 27454
serviceshealth care administration shall establish an outpatient 27455
drug use review program to assure that prescriptions obtained by 27456
recipients of medical assistance under this chapter are 27457
appropriate, medically necessary, and unlikely to cause adverse 27458
medical results.27459

       Sec. 5111.027.        Sec. 5163.242. If the medicaid program provides 27460
prescription drug services to medicaid recipients, the program 27461
shall not provide reimbursement for prescription drugs for 27462
treatment of erectile dysfunction.27463

       Sec. 5111.083.        Sec. 5163.243. (A) As used in this section, 27464
"licensed health professional authorized to prescribe drugs" has 27465
the same meaning as in section 4729.01 of the Revised Code.27466

        (B) The director of job and family serviceshealth care 27467
administration may establish an e-prescribing system for the 27468
medicaid program under which a medicaid provider who is a licensed 27469
health professional authorized to prescribe drugs shall use an 27470
electronic system to prescribe a drug for a medicaid recipient 27471
when required to do so by division (C) of this section. The 27472
e-prescribing system shall eliminate the need for such medicaid 27473
providers to make prescriptions for medicaid recipients by 27474
handwriting or telephone. The e-prescribing system also shall 27475
provide such medicaid providers with an up-to-date, clinically 27476
relevant drug information database and a system of electronically 27477
monitoring medicaid recipients' medical history, drug regimen 27478
compliance, and fraud and abuse.27479

        (C) If the director establishes an e-prescribing system under 27480
division (B) of this section, the director shall do all of the 27481
following:27482

        (1) Require that a medicaid provider who is a licensed health 27483
professional authorized to prescribe drugs use the e-prescribing 27484
system during a fiscal year if the medicaid provider was one of 27485
the ten medicaid providers who, during the calendar year that 27486
precedes that fiscal year, issued the most prescriptions for 27487
medicaid recipients receiving hospital services;27488

        (2) Before the beginning of each fiscal year, determine the 27489
ten medicaid providers that issued the most prescriptions for 27490
medicaid recipients receiving hospital services during the 27491
calendar year that precedes the upcoming fiscal year and notify 27492
those medicaid providers that they must use the e-prescribing 27493
system for the upcoming fiscal year;27494

        (3) Seek the most federal financial participation available 27495
for the development and implementation of the e-prescribing 27496
system.27497

       Sec. 5111.07.        Sec. 5163.25.  Commencing in July, 1986, and every 27498
second July thereafter, the department of job and family services27499
health care administration shall initiate a private survey of 27500
retail pharmacy operations in the state as the basis for 27501
establishing a current maximum dispensing fee for licensed 27502
pharmacists who are providers of drugs under this chapter. The 27503
survey shall be conducted in conformance with the requirements set 27504
forth in 42 C.F.R. 447.331 through 447.333, as amended or 27505
superseded, and shall include operational data and direct 27506
prescription expenses, professional services and personnel costs, 27507
usual and customary overhead expenses, and profit data of the 27508
retail pharmacies surveyed. The survey shall be completed and its 27509
results published no later than the last day of October of the 27510
year in which the survey is conducted, and the survey shall 27511
compute and report dispensing fees on a basis of the usual and 27512
customary charges by retail pharmacies to their customers for27513
dispensing drugs. The director of job and family serviceshealth 27514
care administration shall take into account the results of the 27515
survey in establishing a dispensing fee.27516

       Sec. 5111.071.        Sec. 5163.251.  Commencing in December, 1986, and 27517
every second December thereafter, the director of job and family 27518
serviceshealth care administration shall establish a dispensing 27519
fee, effective the following January, for licensed pharmacists who 27520
are medicaid providers under this chapter. The dispensing fee 27521
shall take into consideration the results of the survey conducted 27522
under section 5111.075163.25 of the Revised Code.27523

       Sec. 5111.081.        Sec. 5163.26.  The director of job and family 27524
serviceshealth care administration, in rules adopted under 27525
section 5111.025163.15 of the Revised Code, may establish and 27526
implement a supplemental drug rebate program under which drug 27527
manufacturers may be required to provide the department of job and 27528
family serviceshealth care administration a supplemental rebate 27529
as a condition of having the drug manufacturers' drug products 27530
covered by the medicaid program without prior approval. The 27531
department may receive a supplemental rebate negotiated under the 27532
program for a drug dispensed to a medicaid recipient pursuant to a 27533
prescription or a drug purchased by a medicaid provider for 27534
administration to a medicaid recipient in the provider's primary 27535
place of business. If necessary, the director may apply to the 27536
United States secretary of health and human services for a waiver 27537
of federal statutes and regulations to establish the supplemental 27538
drug rebate program.27539

       If the director establishes a supplemental drug rebate27540
program, the director shall consult with drug manufacturers27541
regarding the establishment and implementation of the program.27542

       Sec. 5111.0114.        Sec. 5163.261. (A) As used in this section, 27543
"dangerous drug" and "manufacturer of dangerous drugs" have the 27544
same meaning as in section 4729.01 of the Revised Code.27545

        (B) The director of job and family serviceshealth care 27546
administration may enter into or administer an agreement or 27547
cooperative arrangement with other states to create or join a 27548
multiple-state prescription drug purchasing program for the 27549
purpose of negotiating with manufacturers of dangerous drugs to 27550
receive discounts or rebates for dangerous drugs dispensed under 27551
the medicaid program.27552

       Sec. 5111.029.        Sec. 5163.27. The medicaid program shall cover 27553
occupational therapy services provided by an occupational 27554
therapist licensed under section 4755.08 of the Revised Code. 27555
Coverage shall not be limited to services provided in a hospital 27556
or nursing facility. Any licensed occupational therapist may 27557
enter into a medicaid provider agreement with the department of 27558
job and family serviceshealth care administration to provide 27559
occupational therapy services under the medicaid program.27560

       Sec. 5111.042.        Sec. 5163.28.  The departments of mental retardation 27561
and developmental disabilities and job and family serviceshealth 27562
care administration may approve, reduce, deny, or terminate a 27563
service included in the individualized service plan developed for 27564
a medicaid recipient with mental retardation or other 27565
developmental disability who is eligible for medicaid case 27566
management services. If either department approves, reduces, 27567
denies, or terminates a service, that department shall timely 27568
notify the medicaid recipient that the recipient may request a 27569
hearing under section 5101.355160.34 of the Revised Code.27570

       Sec. 5111.71.        Sec. 5163.30. (A) As used in sections 5111.715163.3027571
to 5111.7155163.305 of the Revised Code, "qualified medicaid 27572
school provider" means the board of education of a city, local, 27573
or exempted village school district, the governing authority of a 27574
community school established under Chapter 3314. of the Revised 27575
Code, the state school for the deaf, and the state school for the 27576
blind to which both of the following apply:27577

       (1) It holds a valid medicaid provider agreement. 27578

       (2) It meets all other conditions for participation in the 27579
medicaid school component of the medicaid program established in 27580
rules adopted under section 5111.7155163.305 of the Revised Code.27581

        (B) The director of job and family serviceshealth care 27582
administration shall submit a state medicaid plan amendment to 27583
the United States secretary of health and human services for the 27584
purpose of creating, in accordance with sections 5111.715163.3027585
to 5111.7155163.305 of the Revised Code, the medicaid school 27586
component of the medicaid program. The director shall create the 27587
medicaid school component on receipt of the United States 27588
secretary's approval of the amendment.27589

       Sec. 5111.711.        Sec. 5163.301.  A qualified medicaid school provider 27590
participating in the medicaid school component of the medicaid 27591
program may submit a claim to the department of job and family 27592
serviceshealth care administration for federal financial 27593
participation for providing, in schools, services covered by the 27594
medicaid school component to medicaid recipients who are eligible 27595
for the services. No qualified medicaid school provider may 27596
submit such a claim before the provider incurs the cost of 27597
providing the service.27598

       The claim shall include certification of the qualified 27599
medicaid school provider's expenditures for the service. The 27600
certification shall show that the money the qualified medicaid 27601
school provider used for the expenditures was nonfederal money the 27602
provider may legally use for providing the service and that the 27603
amount of the expenditures was sufficient to pay the full cost of 27604
the service.27605

       Except as otherwise provided in sections 5111.715163.30 to 27606
5111.7155163.305 of the Revised Code and rules adopted under 27607
sections 5111.7135163.303 and 5111.7155163.305 of the Revised 27608
Code, a qualified medicaid school provider is subject to all 27609
conditions of participation in the medicaid program that 27610
generally apply to providers of goods and services under the 27611
medicaid program, including conditions regarding audits and 27612
recovery of overpayments.27613

       Sec. 5111.712.        Sec. 5163.302.  The department of job and family 27614
serviceshealth care administration shall seek federal financial 27615
participation for each claim a qualified medicaid school provider 27616
properly submits to the department under section 5111.71127617
5163.301 of the Revised Code. The department shall disburse the 27618
federal financial participation the department receives from the 27619
federal government for such a claim to the qualified medicaid 27620
school provider that submitted the claim. The department may not 27621
pay the qualified medicaid school provider the nonfederal share 27622
of the cost of the services for which the claim was submitted.27623

       Sec. 5111.713.        Sec. 5163.303.  The department of job and family 27624
serviceshealth care administration shall enter into an 27625
interagency agreement with the department of education under 27626
section 5111.915161.05 of the Revised Code that provides for the 27627
department of education to administer the medicaid school 27628
component of the medicaid program other than the aspects of the 27629
component that sections 5111.715163.30 to 5111.7155163.305 of 27630
the Revised Code require the department of job and family 27631
serviceshealth care administration to administer. The 27632
interagency agreement may include a provision that provides for 27633
the department of education to pay to the department of job and 27634
family serviceshealth care administration the nonfederal share of 27635
a portion of the administrative expenses the department of job 27636
and family serviceshealth care administration incurs in 27637
administering the aspects of the component that the department of 27638
job and family serviceshealth care administration administers.27639

       The department of education shall establish, in rules adopted 27640
under Chapter 119. of the Revised Code, a process by which 27641
qualified medicaid school providers participating in the medicaid 27642
school component pay to the department of education the nonfederal 27643
share of the department's expenses incurred in administering the 27644
component.27645

       Sec. 5111.714.        Sec. 5163.304.  (A) There is hereby created in the 27646
state treasury the medicaid school program administrative fund. 27647

       (B) Both of the following shall be deposited into the 27648
medicaid school program administrative fund:27649

       (1) The federal funds the department of education receives 27650
for the expenses the department incurs in administering the 27651
medicaid school component of the medicaid program;27652

       (2) The money the department collects from qualified medicaid 27653
school providers in the process established in rules adopted 27654
under section 5111.7135163.303 of the Revised Code.27655

       (C) No funds shall be deposited into the medicaid school 27656
program administrative fund in violation of federal statutes or 27657
regulations.27658

       (D) The department of education shall use money in the 27659
medicaid school program administrative fund for both of the 27660
following purposes:27661

       (1) Paying for the expenses the department incurs in 27662
administering the medicaid school component of the medicaid 27663
program;27664

       (2) Paying a qualified medicaid school provider a refund for 27665
any overpayment the provider makes to the department under the 27666
process established in rules adopted under section 5111.71327667
5163.303 of the Revised Code if the process results in an 27668
overpayment.27669

       Sec. 5111.715.        Sec. 5163.305.  The director of job and family 27670
serviceshealth care administration shall adopt rules under 27671
Chapter 119. of the Revised Code as necessary to implement the 27672
medicaid school component of the medicaid program, including 27673
rules that establish or specify all of the following:27674

       (A) Conditions a board of education of a city, local, or 27675
exempted school district, governing authority of a community 27676
school established under Chapter 3314. of the Revised Code, the 27677
state school for the deaf, and the state school for the blind must 27678
meet to participate in the component;27679

       (B) Services the component covers;27680

       (C) Reimbursement rates for the services the component 27681
covers.27682

       Sec. 5111.85.        Sec. 5163.50.  (A) As used in this section and 27683
sections 5111.8515163.51 to 5111.8565163.56 of the Revised Code,27684
"medicaid waiver component" means a component of the medicaid 27685
program authorized by a waiver granted by the United States 27686
department of health and human services under section 1115 or 1915 27687
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.27688
1315 or 1396n. "Medicaid waiver component" does not include a 27689
care management system established under section 5111.165165.0327690
of the Revised Code.27691

       (B) The director of job and family serviceshealth care 27692
administration may adopt rules under Chapter 119. of the Revised 27693
Code governing medicaid waiver components that establish all of 27694
the following:27695

       (1) Eligibility requirements for the medicaid waiver27696
components;27697

       (2) The type, amount, duration, and scope of services the27698
medicaid waiver components provide;27699

       (3) The conditions under which the medicaid waiver components 27700
cover services;27701

       (4) The amount the medicaid waiver components pay for27702
services or the method by which the amount is determined;27703

       (5) The manner in which the medicaid waiver components pay27704
for services;27705

       (6) Safeguards for the health and welfare of medicaid27706
recipients receiving services under a medicaid waiver component;27707

       (7) Procedures for enforcing the rules, including27708
establishing corrective action plans for, and imposing financial27709
and administrative sanctions on, persons and government entities27710
that violate the rules. Sanctions shall include terminating27711
medicaid provider agreements. The procedures shall include due27712
process protections.27713

       (8) Other policies necessary for the efficient administration 27714
of the medicaid waiver components.27715

       (C) The director of job and family serviceshealth care 27716
administration may adopt different rules for the different 27717
medicaid waiver components. The rules shall be consistent with the 27718
terms of the waiver authorizing the medicaid waiver component.27719

       Sec. 5111.84.        Sec. 5163.501. The director of job and family 27720
serviceshealth care administration may not submit a request to 27721
the United States secretary of health and human services for a 27722
medicaid waiver under section 1115 of the "Social Security Act of 27723
1935," 42 U.S.C. 1315, unless the director provides the speaker 27724
of the house of representatives and president of the senate 27725
written notice of the director's intent to submit the request at 27726
least ten days before the date the director submits the request 27727
to the United States secretary. The notice shall include a 27728
detailed explanation of the medicaid waiver the director proposes 27729
to seek.27730

       Sec. 5111.851.        Sec. 5163.51.  (A) As used in sections 5111.85127731
5163.51 to 5111.8555163.55 of the Revised Code:27732

       "Administrative agency" means, with respect to a home and 27733
community-based services medicaid waiver component, the department 27734
of job and family serviceshealth care administration or, if a 27735
state agency or political subdivision contracts with the 27736
department under section 5111.915161.05 of the Revised Code to 27737
administer the component, that state agency or political 27738
subdivision.27739

        "Home and community-based services medicaid waiver component" 27740
means a medicaid waiver component under which home and 27741
community-based services are provided as an alternative to 27742
hospital, nursing facility, or intermediate care facility for the 27743
mentally retarded services.27744

        "Hospital" has the same meaning as in section 3727.01 of the 27745
Revised Code.27746

        "Intermediate care facility for the mentally retarded" has 27747
the same meaning as in section 5111.205164.01 of the Revised 27748
Code.27749

        "Level of care determination" means a determination of 27750
whether an individual needs the level of care provided by a 27751
hospital, nursing facility, or intermediate care facility for the 27752
mentally retarded and whether the individual, if determined to 27753
need that level of care, would receive hospital, nursing facility, 27754
or intermediate care facility for the mentally retarded services 27755
if not for a home and community-based services medicaid waiver 27756
component.27757

       "Medicaid buy-in for workers with disabilities program" means 27758
the component of the medicaid program established under sections 27759
5111.705162.10 to 5111.70115162.1011 of the Revised Code.27760

        "Nursing facility" has the same meaning as in section 5111.2027761
5164.01 of the Revised Code.27762

        "Skilled nursing facility" means a facility certified as a 27763
skilled nursing facility under Title XVIII of the "Social Security 27764
Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amendedfor the 27765
medicare program.27766

        (B) The following requirements apply to each home and 27767
community-based services medicaid waiver component:27768

        (1) Only an individual who qualifies for a component shall 27769
receive that component's services.27770

        (2) A level of care determination shall be made as part of 27771
the process of determining whether an individual qualifies for a 27772
component and shall be made each year after the initial 27773
determination if, during such a subsequent year, the 27774
administrative agency determines there is a reasonable indication 27775
that the individual's needs have changed.27776

        (3) A written plan of care or individual service plan based 27777
on an individual assessment of the services that an individual 27778
needs to avoid needing admission to a hospital, nursing facility, 27779
or intermediate care facility for the mentally retarded shall be 27780
created for each individual determined eligible for a component.27781

        (4) Each individual determined eligible for a component shall 27782
receive that component's services in accordance with the 27783
individual's level of care determination and written plan of care 27784
or individual service plan.27785

        (5) No individual may receive services under a component 27786
while the individual is a hospital inpatient or resident of a 27787
skilled nursing facility, nursing facility, or intermediate care 27788
facility for the mentally retarded.27789

        (6) No individual may receive prevocational, educational, or 27790
supported employment services under a component if the individual 27791
is eligible for such services that are funded with federal funds 27792
provided under 29 U.S.C. 730 or the "Individuals with Disabilities 27793
Education Act," 111 Stat. 37 (1997), 20 U.S.C. 1400, as amended.27794

        (7) Safeguards shall be taken to protect the health and 27795
welfare of individuals receiving services under a component, 27796
including safeguards established in rules adopted under section 27797
5111.855163.50 of the Revised Code and safeguards established by 27798
licensing and certification requirements that are applicable to 27799
the providers of that component's services.27800

        (8) No services may be provided under a component by a 27801
provider that is subject to standards that 42 U.S.C. 1382e(e)(1) 27802
requires be established if the provider fails to comply with the 27803
standards applicable to the provider.27804

        (9) Individuals determined to be eligible for a component, or 27805
such individuals' representatives, shall be informed of that 27806
component's services, including any choices that the individual or 27807
representative may make regarding the component's services, and 27808
given the choice of either receiving services under that component 27809
or, as appropriate, hospital, nursing facility, or intermediate 27810
care facility for the mentally retarded services.27811

       (10) No individual shall lose eligibility for services under 27812
a component, or have the services reduced or otherwise disrupted, 27813
on the basis that the individual also receives services under the 27814
medicaid buy-in for workers with disabilities program.27815

       (11) No individual shall lose eligibility for services under 27816
a component, or have the services reduced or otherwise disrupted, 27817
on the basis that the individual's income or resources increase to 27818
an amount above the eligibility limit for the component if the 27819
individual is participating in the medicaid buy-in for workers 27820
with disabilities program and the amount of the individual's 27821
income or resources does not exceed the eligibility limit for the 27822
medicaid buy-in for workers with disabilities program.27823

       (12) No individual receiving services under a component shall 27824
be required to pay any cost sharing expenses for the services for 27825
any period during which the individual also participates in the 27826
medicaid buy-in for workers with disabilities program.27827

       Sec. 5111.852.        Sec. 5163.52.  The department of job and family 27828
serviceshealth care administration may review and approve, 27829
modify, or deny written plans of care and individual service plans 27830
that section 5111.8515163.51 of the Revised Code requires be 27831
created for individuals determined eligible for a home and 27832
community-based services medicaid waiver component. If a state 27833
agency or political subdivision contracts with the department 27834
under section 5111.915161.05 of the Revised Code to administer a 27835
home and community-based services medicaid waiver component and 27836
approves, modifies, or denies a written plan of care or individual 27837
service plan pursuant to the agency's or subdivision's 27838
administration of the component, the department may review the 27839
agency's or subdivision's approval, modification, or denial and 27840
order the agency or subdivision to reverse or modify the approval, 27841
modification, or denial. The state agency or political subdivision 27842
shall comply with the department's order.27843

        The department of job and family serviceshealth care 27844
administration shall be granted full and immediate access to any 27845
records the department needs to implement its duties under this 27846
section.27847

       Sec. 5111.853.        Sec. 5163.53.  Each administrative agency shall 27848
maintain, for a period of time the department of job and family 27849
serviceshealth care administration shall specify, financial 27850
records documenting the costs of services provided under the home 27851
and community-based services medicaid waiver components that the 27852
agency administers, including records of independent audits. The 27853
administrative agency shall make the financial records available 27854
on request to the United States secretary of health and human 27855
services, United States comptroller general, and their designees.27856

       Sec. 5111.854.        Sec. 5163.54.  Each administrative agency is 27857
financially accountable for funds expended for services provided 27858
under the home and community-based services medicaid waiver 27859
components that the agency administers.27860

       Sec. 5111.855.        Sec. 5163.55.  Each state agency and political 27861
subdivision that enters into a contract with the department of job 27862
and family serviceshealth care administration under section 27863
5111.915161.05 of the Revised Code to administer a home and 27864
community-based services medicaid waiver component, or one or more 27865
aspects of such a component, shall provide the department a 27866
written assurance that the agency or subdivision will not violate 27867
any of the requirements of sections 5111.855163.50 to 5111.85427868
5163.54 of the Revised Code.27869

       Sec. 5111.856.        Sec. 5163.56.  To the extent necessary for the 27870
efficient and economical administration of medicaid waiver 27871
components, the department of job and family serviceshealth care 27872
administration may transfer an individual enrolled in a medicaid 27873
waiver component administered by the department to another 27874
medicaid waiver component the department administers if the 27875
individual is eligible for the medicaid waiver component and the 27876
transfer does not jeopardize the individual's health or safety.27877

       Sec. 5111.86.        Sec. 5163.60. (A) As used in this section:27878

       (1) "Hospital" has the same meaning as in section 3727.01 of 27879
the Revised Code.27880

       (2) "Medicaid waiver component" has the same meaning as in 27881
section 5111.855163.50 of the Revised Code.27882

       (3) "Nursing facility" has the same meaning as in section 27883
5111.205164.01 of the Revised Code.27884

       (4) "Ohio home care program" means the program the department 27885
of job and family serviceshealth care administration administers 27886
that provides state plan services and medicaid waiver component 27887
services pursuant to rules adopted under sections 5111.015162.2027888
and 5111.025163.15 of the Revised Code and a medicaid waiver that 27889
went into effect July 1, 1998.27890

       (B) The director of job and family serviceshealth care 27891
administration may submit requests to the United States secretary 27892
of health and human services pursuant to section 1915 of the 27893
"Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396n, as 27894
amended, to obtain waivers of federal medicaid requirements that 27895
would otherwise be violated in the creation and implementation of 27896
two or more medicaid waiver components under which home and 27897
community-based services are provided to eligible individuals who 27898
need the level of care provided by a nursing facility or hospital. 27899
In the requests, the director may specify the following:27900

        (1) The maximum number of individuals who may be enrolled in 27901
each of the medicaid waiver components included in the requests;27902

        (2) The maximum amount the medicaid program may expend each 27903
year for each individual enrolled in the medicaid waiver 27904
components;27905

        (3) The maximum amount the medicaid program may expend each 27906
year for all individuals enrolled in the medicaid waiver 27907
components;27908

        (4) Any other requirements the director selects for the 27909
medicaid waiver components.27910

       (C) If the secretary approves the medicaid waivers requested 27911
under this section, the director may create and implement the 27912
medicaid waiver components in accordance with the provisions of 27913
the approved waivers. The department of job and family services27914
health care administration shall administer the medicaid waiver 27915
components.27916

       After the first of any medicaid waiver components created 27917
under this section begins to enroll eligible individuals, the 27918
director may submit to the United States secretary of health and 27919
human services an amendment to a medicaid waiver component of the 27920
Ohio home care program authorizing the department to cease 27921
enrolling additional individuals in that medicaid waiver component 27922
of the Ohio home care program. If the secretary approves the 27923
amendment, the director may cease to enroll additional individuals 27924
in that medicaid waiver component of the Ohio home care program.27925

       Sec. 5111.87.        Sec. 5163.65. (A) As used in this section and section 27926
5111.8715163.651 of the Revised Code:27927

       (1) "Intermediate care facility for the mentally retarded" 27928
has the same meaning as in section 5111.205164.01 of the Revised 27929
Code.27930

       (2) "Medicaid waiver component" has the same meaning as in 27931
section 5111.855163.50 of the Revised Code.27932

       (B) The director of job and family serviceshealth care 27933
administration may apply to the United States secretary of health 27934
and human services for both of the following:27935

       (1) One or more medicaid waiver components under which home 27936
and community-based services are provided to individuals with 27937
mental retardation or other developmental disability as an 27938
alternative to placement in an intermediate care facility for the 27939
mentally retarded;27940

        (2) One or more medicaid waiver components under which home 27941
and community-based services are provided in the form of any of 27942
the following:27943

        (a) Early intervention and supportive services for children 27944
under three years of age who have developmental delays or 27945
disabilities the director determines are significant;27946

        (b) Therapeutic services for children who have autism;27947

        (c) Specialized habilitative services for individuals who are 27948
eighteen years of age or older and have autism. 27949

        (C) No medicaid waiver component authorized by division 27950
(B)(2)(b) or (c) of this section shall provide services that are 27951
available under another medicaid waiver component. No medicaid 27952
waiver component authorized by division (B)(2)(b) of this section 27953
shall provide services to an individual that the individual is 27954
eligible to receive through an individualized education program as 27955
defined in section 3323.01 of the Revised Code.27956

        (D) The director of mental retardation and developmental 27957
disabilities or director of health may request that the director 27958
of job and family serviceshealth care administration apply for 27959
one or more medicaid waivers under this section.27960

       (E) Before applying for a waiver under this section, the 27961
director of job and family serviceshealth care administration27962
shall seek, accept, and consider public comments.27963

       Sec. 5111.871.        Sec. 5163.651.  The department of job and family27964
serviceshealth care administration shall enter into a contract 27965
with the department of mental retardation and developmental 27966
disabilities under section 5111.915161.05 of the Revised Code 27967
with regard to one or more of the components of the medicaid27968
program established by the department of job and family services27969
health care administration under one or more of the medicaid 27970
waivers sought under section 5111.875163.65 of the Revised Code. 27971
The contract shall provide for the department of mental 27972
retardation and developmental disabilities to administer the 27973
components in accordance with the terms of the waivers. The 27974
directors of job and family serviceshealth care administration27975
and mental retardation and developmental disabilities shall adopt27976
rules in accordance with Chapter 119. of the Revised Code27977
governing the components.27978

       If the department of mental retardation and developmental27979
disabilities or the department of job and family serviceshealth 27980
care administration denies an individual's application for home 27981
and community-based services provided under any of these medicaid 27982
components, the department that denied the services shall give 27983
timely notice to the individual that the individual may request a 27984
hearing under section 5101.355160.34 of the Revised Code.27985

       The departments of mental retardation and developmental27986
disabilities and job and family serviceshealth care 27987
administration may approve, reduce, deny, or terminate a service 27988
included in the individualized service plan developed for a 27989
medicaid recipient eligible for home and community-based services 27990
provided under any of these medicaid components. The departments 27991
shall consider the recommendations a county board of mental 27992
retardation and developmental disabilities makes under division 27993
(A)(1)(c) of section 5126.055 of the Revised Code. If either 27994
department approves, reduces, denies, or terminates a service, 27995
that department shall give timely notice to the medicaid recipient 27996
that the recipient may request a hearing under section 5101.35 of 27997
the Revised Code.27998

       If supported living, as defined in section 5126.01 of the 27999
Revised Code, is to be provided as a service under any of these 28000
components, any person or government entity with a current, valid28001
medicaid provider agreement and a current, valid certificate 28002
under section 5123.161 of the Revised Code may provide the 28003
service.28004

       If a service is to be provided under any of these components 28005
by a residential facility, as defined in section 5123.19 of the 28006
Revised Code, any person or government entity with a current, 28007
valid medicaid provider agreement and a current, valid license 28008
under section 5123.19 of the Revised Code may provide the service.28009

       Sec. 5111.872.        Sec. 5163.652. When the department of mental 28010
retardation and developmental disabilities allocates enrollment 28011
numbers to a county board of mental retardation and developmental 28012
disabilities for home and community-based services specified in 28013
division (B)(1) of section 5111.875163.65 of the Revised Code 28014
and provided under any of the components of the medicaid program 28015
that the department administers under section 5111.8715163.65128016
of the Revised Code, the department shall consider all of the 28017
following:28018

       (A) The number of individuals with mental retardation or28019
other developmental disability who are on a waiting list the28020
county board establishes under division (C) of section 5126.042 of28021
the Revised Code for those services and are given priority on the28022
waiting list pursuant to division (D) or (E) of that section;28023

       (B) The implementation component required by division (A)(3)28024
of section 5126.054 of the Revised Code of the county board's plan28025
approved under section 5123.046 of the Revised Code;28026

       (C) Anything else the department considers necessary to28027
enable county boards to provide those services to individuals in28028
accordance with the priority requirements of divisions (D) and (E) 28029
of section 5126.042 of the Revised Code.28030

       Sec. 5111.873.        Sec. 5163.653. (A) Not later than the effective date 28031
of the first of any medicaid waivers the United States secretary 28032
of health and human services grants pursuant to a request made 28033
under section 5111.875163.65 of the Revised Code, the director of 28034
job and family serviceshealth care administration shall adopt 28035
rules in accordance with Chapter 119. of the Revised Code 28036
establishing statewide fee schedules for home and community-based 28037
services specified in division (B)(1) of section 5111.875163.6528038
of the Revised Code and provided under the components of the28039
medicaid program that the department of mental retardation and28040
developmental disabilities administers under section 5111.87128041
5163.651 of the Revised Code. The rules shall provide for all of 28042
the following:28043

       (1) The department of mental retardation and developmental28044
disabilities arranging for the initial and ongoing collection of28045
cost information from a comprehensive, statistically valid sample28046
of persons and government entities providing the services at the28047
time the information is obtained;28048

       (2) The collection of consumer-specific information through28049
an assessment instrument the department of mental retardation and28050
developmental disabilities shall provide to the department of job28051
and family serviceshealth care administration;28052

       (3) With the information collected pursuant to divisions28053
(A)(1) and (2) of this section, an analysis of that information,28054
and other information the director determines relevant, methods28055
and standards for calculating the fee schedules that do all of the28056
following:28057

       (a) Assure that the fees are consistent with efficiency,28058
economy, and quality of care;28059

       (b) Consider the intensity of consumer resource need;28060

       (c) Recognize variations in different geographic areas28061
regarding the resources necessary to assure the health and welfare28062
of consumers;28063

       (d) Recognize variations in environmental supports available28064
to consumers.28065

       (B) As part of the process of adopting rules under this28066
section, the director shall consult with the director of mental28067
retardation and developmental disabilities, representatives of28068
county boards of mental retardation and developmental28069
disabilities, persons who provide the home and community-based28070
services, and other persons and government entities the director28071
identifies.28072

       (C) The directors of job and family serviceshealth care 28073
administration and mental retardation and developmental 28074
disabilities shall review the rules adopted under this section at 28075
times they determine to ensure that the methods and standards 28076
established by the rules for calculating the fee schedules 28077
continue to do everything that division (A)(3) of this section 28078
requires.28079

       Sec. 5111.874.        Sec. 5163.66.  (A) As used in sections 5111.87428080
5163.66 to 5111.87105163.666 of the Revised Code:28081

       "Home and community-based services" has the same meaning as 28082
in section 5123.01 of the Revised Code.28083

       "ICF/MR services" means intermediate care facility for the 28084
mentally retarded services covered by the medicaid program that an 28085
intermediate care facility for the mentally retarded provides to a 28086
resident of the facility who is a medicaid recipient eligible for 28087
medicaid-covered intermediate care facility for the mentally 28088
retarded services.28089

       "Intermediate care facility for the mentally retarded" means 28090
an intermediate care facility for the mentally retarded that is 28091
certified as in compliance with applicable standards for the 28092
medicaid program by the director of health in accordance with 28093
Title XIX of the "Social Security Act," 79 Stat. 286 (1965), 42 28094
U.S.C. 1396, as amended, and licensed as a residential facility 28095
under section 5123.19 of the Revised Code.28096

       "Residential facility" has the same meaning as in section 28097
5123.19 of the Revised Code.28098

       (B) For the purpose of increasing the number of slots 28099
available for home and community-based services and subject to 28100
sections 5111.8775163.663 and 5111.8785163.664 of the Revised 28101
Code, the operator of an intermediate care facility for the 28102
mentally retarded may convert all of the beds in the facility 28103
from providing ICF/MR services to providing home and 28104
community-based services if all of the following requirements 28105
are met:28106

       (1) The operator provides the directors of health, job and 28107
family serviceshealth care administration, and mental 28108
retardation and developmental disabilities at least ninety days' 28109
notice of the operator's intent to relinquish the facility's 28110
certification as an intermediate care facility for the mentally 28111
retarded and to begin providing home and community-based 28112
services.28113

       (2) The operator complies with the requirements of sections 28114
5111.655164.82 to 5111.6885164.858 of the Revised Code regarding 28115
a voluntary termination as defined in section 5111.655164.82 of 28116
the Revised Code if those requirements are applicable.28117

       (3) The operator notifies each of the facility's residents 28118
that the facility is to cease providing ICF/MR services and inform 28119
each resident that the resident may do either of the following:28120

       (a) Continue to receive ICF/MR services by transferring to 28121
another facility that is an intermediate care facility for the 28122
mentally retarded willing and able to accept the resident if the 28123
resident continues to qualify for ICF/MR services;28124

       (b) Begin to receive home and community-based services 28125
instead of ICF/MR services from any provider of home and 28126
community-based services that is willing and able to provide the 28127
services to the resident if the resident is eligible for the 28128
services and a slot for the services is available to the resident.28129

       (4) The operator meets the requirements for providing home 28130
and community-based services, including the following:28131

       (a) Such requirements applicable to a residential facility if 28132
the operator maintains the facility's license as a residential 28133
facility;28134

       (b) Such requirements applicable to a facility that is not 28135
licensed as a residential facility if the operator surrenders the 28136
facility's residential facility license under section 5123.19 of 28137
the Revised Code.28138

       (5) The director of mental retardation and developmental 28139
disabilities approves the conversion.28140

       (C) The notice to the director of mental retardation and 28141
developmental disabilities under division (B)(1) of this section 28142
shall specify whether the operator wishes to surrender the 28143
facility's license as a residential facility under section 5123.19 28144
of the Revised Code.28145

       (D) If the director of mental retardation and developmental 28146
disabilities approves a conversion under division (B) of this 28147
section, the director of health shall terminate the certification 28148
of the intermediate care facility for the mentally retarded to be 28149
converted. The director of health shall notify the director of 28150
job and family serviceshealth care administration of the 28151
termination. On receipt of the director of health's notice, the 28152
director of job and family serviceshealth care administration28153
shall terminate the operator's medicaid provider agreement that 28154
authorizes the operator to provide ICF/MR services at the 28155
facility. The operator is not entitled to notice or a hearing 28156
under Chapter 119. of the Revised Code before the director of job 28157
and family serviceshealth care administration terminates the 28158
medicaid provider agreement.28159

       Sec. 5111.875.        Sec. 5163.661. (A) For the purpose of increasing the 28160
number of slots available for home and community-based services 28161
and subject to sections 5111.8775163.663 and 5111.8785163.66428162
of the Revised Code, a person who acquires, through a request 28163
for proposals issued by the director of mental retardation and 28164
developmental disabilities, a residential facility that is an 28165
intermediate care facility for the mentally retarded and for 28166
which the license as a residential facility was previously 28167
surrendered or revoked may convert some or all of the facility's 28168
beds from providing ICF/MR services to providing home and 28169
community-based services if all of the following requirements 28170
are met:28171

       (1) The person provides the directors of health, job and 28172
family serviceshealth care administration, and mental retardation 28173
and developmental disabilities at least ninety days' notice of 28174
the person's intent to make the conversion.28175

       (2) The person complies with the requirements of sections 28176
5111.655164.82 to 5111.6885164.858 of the Revised Code regarding 28177
a voluntary termination as defined in section 5111.655164.82 of 28178
the Revised Code if those requirements are applicable.28179

       (3) If the person intends to convert all of the facility's 28180
beds, the person notifies each of the facility's residents that 28181
the facility is to cease providing ICF/MR services and informs 28182
each resident that the resident may do either of the following:28183

       (a) Continue to receive ICF/MR services by transferring to 28184
another facility that is an intermediate care facility for the 28185
mentally retarded willing and able to accept the resident if the 28186
resident continues to qualify for ICF/MR services;28187

       (b) Begin to receive home and community-based services 28188
instead of ICF/MR services from any provider of home and 28189
community-based services that is willing and able to provide the 28190
services to the resident if the resident is eligible for the 28191
services and a slot for the services is available to the resident.28192

       (4) If the person intends to convert some but not all of the 28193
facility's beds, the person notifies each of the facility's 28194
residents that the facility is to convert some of its beds from 28195
providing ICF/MR services to providing home and community-based 28196
services and inform each resident that the resident may do either 28197
of the following:28198

       (a) Continue to receive ICF/MR services from any provider of 28199
ICF/MR services that is willing and able to provide the services 28200
to the resident if the resident continues to qualify for ICF/MR 28201
services;28202

       (b) Begin to receive home and community-based services 28203
instead of ICF/MR services from any provider of home and 28204
community-based services that is willing and able to provide the 28205
services to the resident if the resident is eligible for the 28206
services and a slot for the services is available to the resident.28207

       (5) The person meets the requirements for providing home and 28208
community-based services at a residential facility.28209

       (B) The notice provided to the directors under division 28210
(A)(1) of this section shall specify whether some or all of the 28211
facility's beds are to be converted. If some but not all of the 28212
beds are to be converted, the notice shall specify how many of 28213
the facility's beds are to be converted and how many of the beds 28214
are to continue to provide ICF/MR services.28215

       (C) On receipt of a notice under division (A)(1) of this 28216
section, the director of health shall do the following:28217

       (1) Terminate the certification of the intermediate care 28218
facility for the mentally retarded if the notice specifies that 28219
all of the facility's beds are to be converted;28220

       (2) Reduce the facility's certified capacity by the number of 28221
beds being converted if the notice specifies that some but not all 28222
of the beds are to be converted.28223

       (D) The director of health shall notify the director of job 28224
and family serviceshealth care administration of the termination 28225
or reduction under division (C) of this section. On receipt of 28226
the director of health's notice, the director of job and family 28227
serviceshealth care administration shall do the following:28228

       (1) Terminate the person's medicaid provider agreement that 28229
authorizes the person to provide ICF/MR services at the facility 28230
if the facility's certification was terminated;28231

       (2) Amend the person's medicaid provider agreement to reflect 28232
the facility's reduced certified capacity if the facility's 28233
certified capacity is reduced.28234

       The person is not entitled to notice or a hearing under 28235
Chapter 119. of the Revised Code before the director of job and 28236
family serviceshealth care administration terminates or amends 28237
the medicaid provider agreement.28238

       Sec. 5111.876.        Sec. 5163.662.  Subject to section 5111.8775163.66328239
of the Revised Code, the director of mental retardation and 28240
developmental disabilities may request that the director of job 28241
and family serviceshealth care administration seek the approval 28242
of the United States secretary of health and human services to 28243
increase the number of slots available for home and 28244
community-based services by a number not exceeding the number of 28245
beds that were part of the licensed capacity of a residential 28246
facility that had its license revoked or surrendered under 28247
section 5123.19 of the Revised Code if the residential facility 28248
was an intermediate care facility for the mentally retarded at 28249
the time of the license revocation or surrender. The revocation 28250
or surrender may have occurred before, or may occur on or after, 28251
the effective date of this sectionJune 24, 2008. The request 28252
may include beds the director removed from such a residential 28253
facility's licensed capacity before transferring ownership or 28254
operation of the residential facility pursuant to a request for 28255
proposals.28256

       Sec. 5111.877.        Sec. 5163.663. The director of job and family 28257
serviceshealth care administration may seek approval from the 28258
United States secretary of health and human services for not more 28259
than a total of one hundred slots for home and community-based 28260
services for the purposes of sections 5111.8745163.66, 5111.87528261
5163.661, and 5111.8765163.662 of the Revised Code.28262

       Sec. 5111.878.        Sec. 5163.664. Not more than a total of one hundred 28263
beds may be converted from providing ICF/MR services to providing 28264
home and community-based services under sections 5111.8745163.6628265
and 5111.8755163.661 of the Revised Code.28266

       Sec. 5111.879.        Sec. 5163.665. No person or government entity may 28267
reconvert a bed to be used for ICF/MR services if the bed was 28268
converted to use for home and community-based services under 28269
section 5111.8745163.66 or 5111.8755163.661 of the Revised 28270
Code. This prohibition applies regardless of either of the 28271
following:28272

       (A) The bed is part of the licensed capacity of a residential 28273
facility.28274

       (B) The bed has been sold, leased, or otherwise transferred 28275
to another person or government entity.28276

       Sec. 5111.8710.        Sec. 5163.666.  The directors of job and family 28277
serviceshealth care administration and mental retardation and 28278
developmental disabilities may adopt rules in accordance with 28279
Chapter 119. of the Revised Code as necessary to implement 28280
sections 5111.8745163.66 to 5111.87105163.666 of the Revised 28281
Code.28282

       Sec. 5111.89.        Sec. 5163.68.  (A) As used in sections 5111.8928283
5163.68 to 5111.8945163.684 of the Revised Code: 28284

       "Area agency on aging" has the same meaning as in section 28285
173.14 of the Revised Code. 28286

       "Assisted living program" means the medicaid waiver component 28287
for which the director of job and family serviceshealth care 28288
administration is authorized by this section to request a 28289
medicaid waiver. 28290

       "Assisted living services" means the following home and 28291
community-based services: personal care, homemaker, chore, 28292
attendant care, companion, medication oversight, and therapeutic 28293
social and recreational programming. 28294

       "County or district home" means a county or district home 28295
operated under Chapter 5155. of the Revised Code. 28296

       "Long-term care consultation program" means the program the 28297
department of aging is required to develop under section 173.42 of 28298
the Revised Code. 28299

       "Long-term care consultation program administrator" or 28300
"administrator" means the department of aging or, if the 28301
department contracts with an area agency on aging or other entity 28302
to administer the long-term care consultation program for a 28303
particular area, that agency or entity. 28304

       "Medicaid waiver component" has the same meaning as in 28305
section 5111.855163.50 of the Revised Code. 28306

       "Nursing facility" has the same meaning as in section 5111.2028307
5164.01 of the Revised Code. 28308

       "Residential care facility" has the same meaning as in 28309
section 3721.01 of the Revised Code. 28310

       "State administrative agency" means the department of job and 28311
family serviceshealth care administration if the department of 28312
job and family serviceshealth care administration administers 28313
the assisted living program or the department of aging if the 28314
department of aging administers the assisted living program. 28315

       (B) The director of job and family serviceshealth care 28316
administration may submit a request to the United States 28317
secretary of health and human services under 42 U.S.C. 1396n to 28318
obtain a waiver of federal medicaid requirements that would 28319
otherwise be violated in the creation and implementation of a 28320
program under which assisted living services are provided to not 28321
more than one thousand eight hundred individuals who meet the 28322
program's eligibility requirements established under section 28323
5111.8915163.681 of the Revised Code. 28324

       If the secretary approves the medicaid waiver requested under 28325
this section and the director of budget and management approves 28326
the contract, the department of job and family serviceshealth 28327
care administration shall enter into a contract with the 28328
department of aging under section 5111.915161.05 of the Revised 28329
Code that provides for the department of aging to administer the 28330
assisted living program. The contract shall include an estimate 28331
of the program's costs. 28332

       The director of job and family serviceshealth care 28333
administration may adopt rules under section 5111.855163.50 of 28334
the Revised Code regarding the assisted living program. The 28335
director of aging may adopt rules under Chapter 119. of the 28336
Revised Code regarding the program that the rules adopted by the 28337
director of job and family serviceshealth care administration28338
authorize the director of aging to adopt. 28339

       Sec. 5111.891.        Sec. 5163.681.  To be eligible for the assisted 28340
living program, an individual must meet all of the following 28341
requirements: 28342

       (A) Need an intermediate level of care as determined under 28343
rule 5101:3-3-06 of the Administrative Code; 28344

       (B) At the time the individual applies for the assisted 28345
living program, be one of the following: 28346

       (1) A nursing facility resident who is seeking to move to a 28347
residential care facility and would remain in a nursing facility 28348
for long term care if not for the assisted living program; 28349

       (2) A participant of any of the following medicaid waiver 28350
components who would move to a nursing facility if not for the 28351
assisted living program: 28352

       (a) The PASSPORT program created under section 173.40 of the 28353
Revised Code; 28354

       (b) The medicaid waiver component called the choices program 28355
that the department of aging administers; 28356

       (c) A medicaid waiver component that the department of job 28357
and family serviceshealth care administration administers. 28358

       (3) A resident of a residential care facility who has resided 28359
in a residential care facility for at least six months immediately 28360
before the date the individual applies for the assisted living 28361
program. 28362

       (C) At the time the individual receives assisted living 28363
services under the assisted living program, reside in a 28364
residential care facility that is authorized by a valid medicaid 28365
provider agreement to participate in the assisted living program, 28366
including both of the following: 28367

       (1) A residential care facility that is owned or operated by 28368
a metropolitan housing authority that has a contract with the 28369
United States department of housing and urban development to 28370
receive an operating subsidy or rental assistance for the 28371
residents of the facility; 28372

       (2) A county or district home licensed as a residential care 28373
facility. 28374

       (D) Meet all other eligibility requirements for the assisted 28375
living program established in rules adopted under section 5111.8528376
5163.50 of the Revised Code. 28377

       Sec. 5111.892.        Sec. 5163.682.  A residential care facility 28378
providing services covered by the assisted living program to an 28379
individual enrolled in the program shall have staff on-site 28380
twenty-four hours each day who are able to do all of the 28381
following:28382

       (A) Meet the scheduled and unpredicted needs of the 28383
individuals enrolled in the assisted living program in a manner 28384
that promotes the individuals' dignity and independence;28385

       (B) Provide supervision services for those individuals;28386

       (C) Help keep the individuals safe and secure.28387

       Sec. 5111.893.        Sec. 5163.683.  If the United States secretary of 28388
health and human services approves a medicaid waiver authorizing 28389
the assisted living program, the director of aging shall contract 28390
with a person or government entity to evaluate the program's cost 28391
effectiveness. The director shall provide the results of the 28392
evaluation to the governor, president and minority leader of the 28393
senate, and speaker and minority leader of the house of 28394
representatives not later than June 30, 2007.28395

       Sec. 5111.894.        Sec. 5163.684.  The state administrative agency may 28396
establish one or more waiting lists for the assisted living 28397
program. Only individuals eligible for the medicaid program may be 28398
placed on a waiting list. 28399

        Each month, each area agency on aging shall determine 28400
whether any individual who resides in the area that the area 28401
agency on aging serves and is on a waiting list for the assisted 28402
living program has been admitted to a nursing facility. If an 28403
area agency on aging determines that such an individual has been 28404
admitted to a nursing facility and that there is a vacancy in a 28405
residential care facility participating in the assisted living 28406
program that is acceptable to the individual, the agency shall 28407
notify the long-term care consultation program administrator 28408
serving the area in which the individual resides about the 28409
determination. The administrator shall determine whether the 28410
assisted living program is appropriate for the individual and 28411
whether the individual would rather participate in the assisted 28412
living program than continue residing in the nursing facility. 28413
If the administrator determines that the assisted living 28414
program is appropriate for the individual and the individual 28415
would rather participate in the assisted living program than 28416
continue residing in the nursing facility, the administrator 28417
shall so notify the state administrative agency. 28418

       On receipt of the notice from the administrator, the state 28419
administrative agency shall approve the individual's enrollment in 28420
the assisted living program regardless of any waiting list for the 28421
assisted living program, unless the enrollment would cause the 28422
assisted living program to exceed the limit on the number of 28423
individuals who may participate in the program as set by section 28424
5111.895163.68 of the Revised Code. Each quarter, the state 28425
administrative agency shall certify to the director of budget 28426
and management the estimated increase in costs of the assisted 28427
living program resulting from enrollment of individuals in the 28428
assisted living program pursuant to this section. 28429

       Not later than the last day of each calendar year, the 28430
director of job and family serviceshealth care administration28431
shall submit to the general assembly a report regarding the 28432
number of individuals enrolled in the assisted living program 28433
pursuant to this section and the costs incurred and savings 28434
achieved as a result of the enrollments. 28435

       Sec. 5111.971.        Sec. 5163.69.  (A) As used in this section, 28436
"long-term care medicaid waiver component" means any of the 28437
following:28438

       (1) The PASSPORT program created under section 173.40 of the 28439
Revised Code;28440

       (2) The medicaid waiver component called the choices program 28441
that the department of aging administers;28442

       (3) A medicaid waiver component that the department of job 28443
and family serviceshealth care administration administers.28444

       (B) The director of job and family serviceshealth care 28445
administration shall submit a request to the United States 28446
secretary of health and human services for a waiver of federal 28447
medicaid requirements that would be otherwise violated in the 28448
creation of a pilot program under which not more than two hundred 28449
individuals who meet the pilot program's eligibility requirements 28450
specified in division (D) of this section receive a spending 28451
authorization to pay for the cost of medically necessary home and 28452
community-based services that the pilot program covers. The 28453
spending authorization shall be in an amount not exceeding seventy 28454
per cent of the average cost under the medicaid program for 28455
providing nursing facility services to an individual. An 28456
individual participating in the pilot program shall also receive 28457
necessary support services, including fiscal intermediary and 28458
other case management services, that the pilot program covers.28459

       (C) If the United States secretary of health and human 28460
services approves the waiver submitted under division (B) of this 28461
section, the department of job and family serviceshealth care 28462
administration shall enter into a contract with the department of 28463
aging under section 5111.915161.05 of the Revised Code that 28464
provides for the department of aging to administer the pilot 28465
program that the waiver authorizes.28466

       (D) To be eligible to participate in the pilot program 28467
created under division (B) of this section, an individual must 28468
meet all of the following requirements:28469

       (1) Need an intermediate level of care as determined under 28470
rule 5101:3-3-06 of the Administrative Code or a skilled level of 28471
care as determined under rule 5101:3-3-05 of the Administrative 28472
Code;28473

       (2) At the time the individual applies to participate in the 28474
pilot program, be one of the following:28475

       (a) A nursing facility resident who would remain in a nursing 28476
facility if not for the pilot program;28477

       (b) A participant of any long-term care medicaid waiver 28478
component who would move to a nursing facility if not for the 28479
pilot program.28480

       (3) Meet all other eligibility requirements for the pilot 28481
program established in rules adopted under section 5111.855163.5028482
of the Revised Code.28483

       (E) The director of job and family serviceshealth care 28484
administration may adopt rules under section 5111.855163.50 of 28485
the Revised Code as the director considers necessary to implement 28486
the pilot program created under division (B) of this section. The 28487
director of aging may adopt rules under Chapter 119. of the 28488
Revised Code as the director considers necessary for the pilot 28489
program's implementation. The rules may establish a list of 28490
medicaid-covered services not covered by the pilot program that an 28491
individual participating in the pilot program may not receive if 28492
the individual also receives medicaid-covered services outside of 28493
the pilot program.28494

       Sec. 5111.97.        Sec. 5163.73. (A) As used in this section and in 28495
section 5111.9715163.69 of the Revised Code, "nursing facility" 28496
has the same meaning as in section 5111.205164.01 of the Revised 28497
Code.28498

       (B) To the extent funds are available, the director of job 28499
and family serviceshealth care administration may establish the28500
Ohio access success project to help medicaid recipients make the28501
transition from residing in a nursing facility to residing in a28502
community setting. The program may be established as a separate 28503
non-medicaidnonmedicaid program or integrated into a new or 28504
existing program of medicaid-funded home and community-based 28505
services authorized by a waiver approved by the United States 28506
department of health and human services. The director shall permit 28507
any recipient of medicaid-funded nursing facility services to 28508
apply for participation in the program, but may limit the number 28509
of program participants. If an application is received before the 28510
applicant has been a recipient of medicaid-funded nursing facility 28511
services for six months, the director shall ensure that an 28512
assessment is conducted as soon as practicable to determine 28513
whether the applicant is eligible for participation in the 28514
program. To the maximum extent possible, the assessment and 28515
eligibility determination shall be completed not later than the 28516
date that occurs six months after the applicant became a recipient 28517
of medicaid-funded nursing facility services.28518

        (C) To be eligible for benefits under the project, a medicaid28519
recipient must satisfy all of the following requirements:28520

       (1) Be a recipient of medicaid-funded nursing facility 28521
services, at the time of applying for the benefits;28522

       (2) Need the level of care provided by nursing facilities;28523

        (3) For participation in a non-medicaidnonmedicaid program, 28524
receive services to remain in the community with a projected cost 28525
not exceeding eighty per cent of the average monthly medicaid cost 28526
of a medicaid recipient in a nursing facility;28527

        (4) For participation in a program established as part of a 28528
medicaid-funded home and community-based services waiver program, 28529
meet waiver enrollment criteria.28530

        (D) If the director establishes the Ohio access success 28531
project, the benefits provided under the project may include 28532
payment of all of the following:28533

       (1) The first month's rent in a community setting;28534

       (2) Rental deposits;28535

       (3) Utility deposits;28536

       (4) Moving expenses;28537

       (5) Other expenses not covered by the medicaid program that28538
facilitate a medicaid recipient's move from a nursing facility to28539
a community setting.28540

        (E) If the project is established as a non-medicaid28541
nonmedicaid program, no participant may receive more than two 28542
thousand dollars worth of benefits under the project.28543

        (F) The director may submit a request to the United States 28544
secretary of health and human services pursuant to section 1915 of 28545
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396n, 28546
as amended, to create a medicaid home and community-based services 28547
waiver program to serve individuals who meet the criteria for 28548
participation in the Ohio access success project. The director may 28549
adopt rules under Chapter 119. of the Revised Code for the 28550
administration and operation of the program.28551

       Sec. 5111.20.        Sec. 5164.01.  As used in sections 5111.205164.01 to 28552
5111.345164.47 of the Revised Code:28553

       (A) "Allowable costs" are those costs determined by the28554
department of job and family serviceshealth care administration28555
to be reasonable and do not include fines paid under sections 28556
5111.355164.50 to 5111.615164.78 and section 5111.995164.99 of 28557
the Revised Code.28558

       (B) "Ancillary and support costs" means all reasonable costs 28559
incurred by a nursing facility other than direct care costs or 28560
capital costs. "Ancillary and support costs" includes, but is not 28561
limited to, costs of activities, social services, pharmacy 28562
consultants, habilitation supervisors, qualified mental 28563
retardation professionals, program directors, medical and 28564
habilitation records, program supplies, incontinence supplies, 28565
food, enterals, dietary supplies and personnel, laundry, 28566
housekeeping, security, administration, medical equipment, 28567
utilities, liability insurance, bookkeeping, purchasing 28568
department, human resources, communications, travel, dues, license 28569
fees, subscriptions, home office costs not otherwise allocated, 28570
legal services, accounting services, minor equipment, maintenance 28571
and repairs, help-wanted advertising, informational advertising, 28572
start-up costs, organizational expenses, other interest, property 28573
insurance, employee training and staff development, employee 28574
benefits, payroll taxes, and workers' compensation premiums or 28575
costs for self-insurance claims and related costs as specified in 28576
rules adopted by the director of job and family services under 28577
section 5111.025163.15 of the Revised Code, for personnel listed 28578
in this division. "Ancillary and support costs" also means the 28579
cost of equipment, including vehicles, acquired by operating 28580
lease executed before December 1, 1992, if the costs are reported 28581
as administrative and general costs on the facility's cost report 28582
for the cost reporting period ending December 31, 1992.28583

       (C) "Capital costs" means costs of ownership and, in the case 28584
of an intermediate care facility for the mentally retarded, costs 28585
of nonextensive renovation.28586

       (1) "Cost of ownership" means the actual expense incurred for 28587
all of the following:28588

       (a) Depreciation and interest on any capital assets that cost 28589
five hundred dollars or more per item, including the following:28590

       (i) Buildings;28591

       (ii) Building improvements that are not approved as28592
nonextensive renovations under section 5111.2515164.08 of the28593
Revised Code;28594

       (iii) Except as provided in division (B) of this section, 28595
equipment;28596

       (iv) In the case of an intermediate care facility for the 28597
mentally retarded, extensive renovations;28598

       (v) Transportation equipment.28599

       (b) Amortization and interest on land improvements and28600
leasehold improvements;28601

       (c) Amortization of financing costs;28602

       (d) Except as provided in division (K) of this section, lease 28603
and rent of land, building, and equipment.28604

       The costs of capital assets of less than five hundred dollars28605
per item may be considered capital costs in accordance with a28606
provider's practice.28607

       (2) "Costs of nonextensive renovation" means the actual28608
expense incurred by an intermediate care facility for the mentally 28609
retarded for depreciation or amortization and interest on28610
renovations that are not extensive renovations.28611

       (D) "Capital lease" and "operating lease" shall be construed28612
in accordance with generally accepted accounting principles.28613

       (E) "Case-mix score" means the measure determined under 28614
section 5164.051 of the Revised Code of the relative direct-care 28615
resources needed to provide care and habilitation to a resident of 28616
an intermediate care facility for the mentally retarded and the 28617
measure determined under section 5111.2325164.191 of the Revised 28618
Code of the relative direct-care resources needed to provide care 28619
and habilitation to a resident of a nursing facility or 28620
intermediate care facility for the mentally retarded.28621

       (F)(1) "Date of licensure," for a facility originally 28622
licensed as a nursing home under Chapter 3721. of the Revised 28623
Code, means the date specific beds were originally licensed as28624
nursing home beds under that chapter, regardless of whether they 28625
were subsequently licensed as residential facility beds under 28626
section 5123.19 of the Revised Code. For a facility originally 28627
licensed as a residential facility under section 5123.19 of the 28628
Revised Code, "date of licensure" means the date specific beds 28629
were originally licensed as residential facility beds under that28630
section.28631

        If nursing home beds licensed under Chapter 3721. of the28632
Revised Code or residential facility beds licensed under section28633
5123.19 of the Revised Code were not required by law to be28634
licensed when they were originally used to provide nursing home or28635
residential facility services, "date of licensure" means the date28636
the beds first were used to provide nursing home or residential28637
facility services, regardless of the date the present provider28638
obtained licensure.28639

        If a facility adds nursing home beds or residential facility 28640
beds or extensively renovates all or part of the facility after 28641
its original date of licensure, it will have a different date of 28642
licensure for the additional beds or extensively renovated portion 28643
of the facility, unless the beds are added in a space that was 28644
constructed at the same time as the previously licensed beds but 28645
was not licensed under Chapter 3721. or section 5123.19 of the28646
Revised Code at that time.28647

       (2) The definition of "date of licensure" in this section 28648
applies in determinations of the medicaid reimbursement rate for a 28649
nursing facility or intermediate care facility for the mentally 28650
retarded but does not apply in determinations of the franchise 28651
permit fee for a nursing facility or intermediate care facility 28652
for the mentally retarded.28653

       (G) "Desk-reviewed" means that costs as reported on a cost28654
report submitted under section 5111.265164.37 of the Revised Code 28655
have been subjected to a desk review under division (A) of section28656
5111.275164.38 of the Revised Code and preliminarily determined 28657
to be allowable costs.28658

       (H) "Direct care costs" means all of the following:28659

       (1)(a) Costs for registered nurses, licensed practical28660
nurses, and nurse aides employed by the facility;28661

       (b) Costs for direct care staff, administrative nursing28662
staff, medical directors, respiratory therapists, and except as 28663
provided in division (H)(2) of this section, other persons holding 28664
degrees qualifying them to provide therapy;28665

       (c) Costs of purchased nursing services;28666

       (d) Costs of quality assurance;28667

       (e) Costs of training and staff development, employee28668
benefits, payroll taxes, and workers' compensation premiums or28669
costs for self-insurance claims and related costs as specified in28670
rules adopted by the director of job and family services in28671
accordance with Chapter 119.under section 5163.15 of the Revised 28672
Code, for personnel listed in divisions (H)(1)(a), (b), and (d) of 28673
this section;28674

       (f) Costs of consulting and management fees related to direct 28675
care;28676

       (g) Allocated direct care home office costs.28677

       (2) In addition to the costs specified in division (H)(1) of 28678
this section, for nursing facilities only, direct care costs 28679
include costs of habilitation staff (other than habilitation 28680
supervisors), medical supplies, emergency oxygen, habilitation 28681
supplies, and universal precautions supplies.28682

       (3) In addition to the costs specified in division (H)(1) of28683
this section, for intermediate care facilities for the mentally28684
retarded only, direct care costs include both of the following:28685

       (a) Costs for physical therapists and physical therapy28686
assistants, occupational therapists and occupational therapy28687
assistants, speech therapists, audiologists, habilitation staff 28688
(including habilitation supervisors), qualified mental retardation 28689
professionals, program directors, social services staff, 28690
activities staff, off-site day programming, psychologists and 28691
psychology assistants, and social workers and counselors;28692

       (b) Costs of training and staff development, employee28693
benefits, payroll taxes, and workers' compensation premiums or28694
costs for self-insurance claims and related costs as specified in28695
rules adopted under section 5111.025163.15 of the Revised Code, 28696
for personnel listed in division (H)(3)(a) of this section.28697

       (4) Costs of other direct-care resources that are specified28698
as direct care costs in rules adopted under section 5111.0228699
5163.15 of the Revised Code.28700

       (I) "Fiscal year" means the fiscal year of this state, as28701
specified in section 9.34 of the Revised Code.28702

       (J) "Franchise permit fee" means the following:28703

       (1) In the context of nursing facilities, the fee imposed by 28704
sections 3721.505166.20 to 3721.585166.30 of the Revised Code;28705

       (2) In the context of intermediate care facilities for the 28706
mentally retarded, the fee imposed by sections 5112.305166.40 to 28707
5112.395166.50 of the Revised Code.28708

        (K) "Indirect care costs" means all reasonable costs incurred 28709
by an intermediate care facility for the mentally retarded other28710
than direct care costs, other protected costs, or capital costs.28711
"Indirect care costs" includes but is not limited to costs of28712
habilitation supplies, pharmacy consultants, medical and28713
habilitation records, program supplies, incontinence supplies,28714
food, enterals, dietary supplies and personnel, laundry,28715
housekeeping, security, administration, liability insurance,28716
bookkeeping, purchasing department, human resources,28717
communications, travel, dues, license fees, subscriptions, home28718
office costs not otherwise allocated, legal services, accounting28719
services, minor equipment, maintenance and repairs, help-wanted28720
advertising, informational advertising, start-up costs,28721
organizational expenses, other interest, property insurance,28722
employee training and staff development, employee benefits,28723
payroll taxes, and workers' compensation premiums or costs for28724
self-insurance claims and related costs as specified in rules28725
adopted under section 5111.025163.15 of the Revised Code, for 28726
personnel listed in this division. Notwithstanding division (C)(1) 28727
of this section, "indirect care costs" also means the cost of 28728
equipment, including vehicles, acquired by operating lease 28729
executed before December 1, 1992, if the costs are reported as 28730
administrative and general costs on the facility's cost report for 28731
the cost reporting period ending December 31, 1992.28732

       (L) "Inpatient days" means all days during which a resident,28733
regardless of payment source, occupies a bed in a nursing facility28734
or intermediate care facility for the mentally retarded that is28735
included in the facility's certified capacity under Title XIX. 28736
Therapeutic or hospital leave days for which payment is made under 28737
section 5111.335164.35 of the Revised Code are considered28738
inpatient days proportionate to the percentage of the facility's28739
per resident per day rate paid for those days.28740

       (M) "Intermediate care facility for the mentally retarded"28741
means an intermediate care facility for the mentally retarded28742
certified as in compliance with applicable standards for the 28743
medicaid program by the director of health in accordance with 28744
Title XIX.28745

       (N) "Maintenance and repair expenses" means, except as28746
provided in division (BB)(2) of this section, expenditures that28747
are necessary and proper to maintain an asset in a normally28748
efficient working condition and that do not extend the useful life 28749
of the asset two years or more. "Maintenance and repair expenses"28750
includes but is not limited to the cost of ordinary repairs such28751
as painting and wallpapering.28752

       (O) "Medicaid days" means all days during which a resident 28753
who is a Medicaid recipient eligible for nursing facility services 28754
occupies a bed in a nursing facility that is included in the 28755
nursing facility's certified capacity under Title XIX. Therapeutic 28756
or hospital leave days for which payment is made under section 28757
5111.335164.35 of the Revised Code are considered Medicaid days 28758
proportionate to the percentage of the nursing facility's per 28759
resident per day rate paid for those days.28760

        (P) "Nursing facility" means a facility, or a distinct part28761
of a facility, that is certified as a nursing facility by the28762
director of health in accordance with Title XIXfor the medicaid 28763
program and is not an intermediate care facility for the mentally 28764
retarded. "Nursing facility" includes a facility, or a distinct 28765
part of a facility, that is certified as a nursing facility by 28766
the director of health in accordance with Title XIXfor the 28767
medicaid program and is certified as a skilled nursing facility by 28768
the director in accordance with Title XVIIIfor the medicare 28769
program.28770

       (Q) "Operator" means the person or government entity 28771
responsible for the daily operating and management decisions for a 28772
nursing facility or intermediate care facility for the mentally 28773
retarded.28774

       (R) "Other protected costs" means costs incurred by an 28775
intermediate care facility for the mentally retarded for medical28776
supplies; real estate, franchise, and property taxes; natural gas,28777
fuel oil, water, electricity, sewage, and refuse and hazardous28778
medical waste collection; allocated other protected home office28779
costs; and any additional costs defined as other protected costs28780
in rules adopted under section 5111.025163.15 of the Revised 28781
Code.28782

       (S)(1) "Owner" means any person or government entity that has28783
at least five per cent ownership or interest, either directly,28784
indirectly, or in any combination, in any of the following 28785
regarding a nursing facility or intermediate care facility for the 28786
mentally retarded:28787

       (a) The land on which the facility is located;28788

       (b) The structure in which the facility is located;28789

       (c) Any mortgage, contract for deed, or other obligation 28790
secured in whole or in part by the land or structure on or in 28791
which the facility is located;28792

       (d) Any lease or sublease of the land or structure on or in 28793
which the facility is located.28794

       (2) "Owner" does not mean a holder of a debenture or bond 28795
related to the nursing facility or intermediate care facility for 28796
the mentally retarded and purchased at public issue or a regulated 28797
lender that has made a loan related to the facility unless the 28798
holder or lender operates the facility directly or through a 28799
subsidiary.28800

       (T) "Patient" includes "resident."28801

       (U) Except as provided in divisions (U)(1) and (2) of this28802
section, "per diem" means a nursing facility's or intermediate28803
care facility for the mentally retarded's actual, allowable costs28804
in a given cost center in a cost reporting period, divided by the28805
facility's inpatient days for that cost reporting period.28806

       (1) When calculating indirect care costs for the purpose of28807
establishing rates under section 5111.2415164.07 of the Revised 28808
Code, "per diem" means an intermediate care facility for the 28809
mentally retarded's actual, allowable indirect care costs in a 28810
cost reporting period divided by the greater of the facility's 28811
inpatient days for that period or the number of inpatient days the 28812
facility would have had during that period if its occupancy rate 28813
had been eighty-five per cent.28814

       (2) When calculating capital costs for the purpose of28815
establishing rates under section 5111.2515164.08 of the Revised 28816
Code, "per diem" means a facility's actual, allowable capital 28817
costs in a cost reporting period divided by the greater of the 28818
facility's inpatient days for that period or the number of28819
inpatient days the facility would have had during that period if28820
its occupancy rate had been ninety-five per cent.28821

       (V) "Provider" means an operator with a provider agreement.28822

       (W) "Provider agreement" means a contract between the28823
department of job and family serviceshealth care administration28824
and the operator of a nursing facility or intermediate care 28825
facility for the mentally retarded for the provision of nursing 28826
facility services or intermediate care facility services for the 28827
mentally retarded under the medicaid program.28828

       (X) "Purchased nursing services" means services that are28829
provided in a nursing facility by registered nurses, licensed28830
practical nurses, or nurse aides who are not employees of the28831
facility.28832

       (Y) "Reasonable" means that a cost is an actual cost that is28833
appropriate and helpful to develop and maintain the operation of28834
patient care facilities and activities, including normal standby28835
costs, and that does not exceed what a prudent buyer pays for a28836
given item or services. Reasonable costs may vary from provider to 28837
provider and from time to time for the same provider.28838

       (Z) "Related party" means an individual or organization that, 28839
to a significant extent, has common ownership with, is associated 28840
or affiliated with, has control of, or is controlled by, the 28841
provider.28842

       (1) An individual who is a relative of an owner is a related28843
party.28844

       (2) Common ownership exists when an individual or individuals 28845
possess significant ownership or equity in both the provider and 28846
the other organization. Significant ownership or equity exists 28847
when an individual or individuals possess five per cent ownership 28848
or equity in both the provider and a supplier. Significant 28849
ownership or equity is presumed to exist when an individual or 28850
individuals possess ten per cent ownership or equity in both the 28851
provider and another organization from which the provider 28852
purchases or leases real property.28853

       (3) Control exists when an individual or organization has the 28854
power, directly or indirectly, to significantly influence or28855
direct the actions or policies of an organization.28856

       (4) An individual or organization that supplies goods or28857
services to a provider shall not be considered a related party if28858
all of the following conditions are met:28859

       (a) The supplier is a separate bona fide organization.28860

       (b) A substantial part of the supplier's business activity of 28861
the type carried on with the provider is transacted with others28862
than the provider and there is an open, competitive market for the28863
types of goods or services the supplier furnishes.28864

       (c) The types of goods or services are commonly obtained by28865
other nursing facilities or intermediate care facilities for the28866
mentally retarded from outside organizations and are not a basic28867
element of patient care ordinarily furnished directly to patients28868
by the facilities.28869

       (d) The charge to the provider is in line with the charge for 28870
the goods or services in the open market and no more than the28871
charge made under comparable circumstances to others by the28872
supplier.28873

       (AA) "Relative of owner" means an individual who is related28874
to an owner of a nursing facility or intermediate care facility28875
for the mentally retarded by one of the following relationships:28876

       (1) Spouse;28877

       (2) Natural parent, child, or sibling;28878

       (3) Adopted parent, child, or sibling;28879

       (4) Stepparent, stepchild, stepbrother, or stepsister;28880

       (5) Father-in-law, mother-in-law, son-in-law,28881
daughter-in-law, brother-in-law, or sister-in-law;28882

       (6) Grandparent or grandchild;28883

       (7) Foster caregiver, foster child, foster brother, or foster 28884
sister.28885

       (BB) "Renovation" and "extensive renovation" mean:28886

       (1) Any betterment, improvement, or restoration of an 28887
intermediate care facility for the mentally retarded started 28888
before July 1, 1993, that meets the definition of a renovation or 28889
extensive renovation established in rules adopted by the director 28890
of job and family services in effect on December 22, 1992.28891

       (2) In the case of betterments, improvements, and28892
restorations of intermediate care facilities for the mentally 28893
retarded started on or after July 1, 1993:28894

       (a) "Renovation" means the betterment, improvement, or28895
restoration of an intermediate care facility for the mentally 28896
retarded beyond its current functional capacity through a 28897
structural change that costs at least five hundred dollars per 28898
bed. A renovation may include betterment, improvement, 28899
restoration, or replacement of assets that are affixed to the 28900
building and have a useful life of at least five years. A 28901
renovation may include costs that otherwise would be considered 28902
maintenance and repair expenses if they are an integral part of 28903
the structural change that makes up the renovation project.28904
"Renovation" does not mean construction of additional space for 28905
beds that will be added to a facility's licensed or certified 28906
capacity.28907

       (b) "Extensive renovation" means a renovation that costs more 28908
than sixty-five per cent and no more than eighty-five per cent of 28909
the cost of constructing a new bed and that extends the useful 28910
life of the assets for at least ten years.28911

       For the purposes of division (BB)(2) of this section, the28912
cost of constructing a new bed shall be considered to be forty28913
thousand dollars, adjusted for the estimated rate of inflation28914
from January 1, 1993, to the end of the calendar year during which 28915
the renovation is completed, using the consumer price index for28916
shelter costs for all urban consumers for the north central28917
region, as published by the United States bureau of labor28918
statistics.28919

       The department of job and family serviceshealth care 28920
administration may treat a renovation that costs more than 28921
eighty-five per cent of the cost of constructing new beds as an 28922
extensive renovation if the department determines that the 28923
renovation is more prudent than construction of new beds.28924

       (CC) "Title XIX" means Title XIX of the "Social Security 28925
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended.28926

        (DD) "Title XVIII" means Title XVIII of the "Social Security 28927
Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended.28928

       Sec. 5111.201.        Sec. 5164.011.  Whenever "skilled nursing facility,"28929
"intermediate care facility," or "dual skilled nursing and 28930
intermediate care facility" is referred to or designated in any 28931
statute, rule, contract, provider agreement, or other document 28932
pertaining to the medical assistancemedicaid program, the28933
reference or designation is deemed to refer to a nursing facility, 28934
except that a reference to or designation of an "intermediate care 28935
facility for the mentally retarded" is not deemed to refer to a 28936
nursing facility.28937

       Sec. 5111.21.        Sec. 5164.02.  (A) In order to be eligible for 28938
medicaid payments, the operator of a nursing facility or 28939
intermediate care facility for the mentally retarded shall do all 28940
of the following:28941

       (1) Enter into a provider agreement with the department of 28942
health care administration as provided in section 5111.225164.03, 28943
5111.6715164.841, or 5111.6725164.842 of the Revised Code;28944

       (2) Apply for and maintain a valid license to operate if so 28945
required by law;28946

       (3) Comply with all applicable state and federal laws and28947
rules.28948

       (B)(1) Except as provided in division (B)(2) of this section, 28949
the operator of a nursing facility that elects to obtain and 28950
maintain eligibility for payments under the medicaid program shall 28951
qualify all of the facility's medicaid-certified beds in the 28952
medicare program established by Title XVIII. The director of job 28953
and family serviceshealth care administration may adopt rules 28954
under section 5111.025163.15 of the Revised Code to establish the 28955
time frame in which a nursing facility must comply with this 28956
requirement.28957

       (2) The Ohio veteran's home agency is not required to qualify 28958
all of the medicaid-certified beds in a nursing facility the 28959
agency maintains and operates under section 5907.01 of the Revised 28960
Code in the medicare program.28961

       Sec. 5111.22.        Sec. 5164.03.  A provider agreement between the 28962
department of job and family serviceshealth care administration28963
and the provider of a nursing facility or intermediate care28964
facility for the mentally retarded shall contain the following28965
provisions:28966

       (A) The department agrees to make payments to the provider, 28967
as provided in sections 5111.205164.01 to 5111.335164.47 of the 28968
Revised Code, for medicaid-covered services the facility provides 28969
to a resident of the facility who is a medicaid recipient. No28970
payment shall be made for the day a medicaid recipient is 28971
discharged from the facility.28972

       (B) The provider agrees to:28973

       (1) Maintain eligibility as provided in section 5111.2128974
5164.02 of the Revised Code;28975

       (2) Keep records relating to a cost reporting period for the28976
greater of seven years after the cost report is filed or, if the28977
department issues an audit report in accordance with division (B)28978
of section 5111.275164.38 of the Revised Code, six years after 28979
all appeal rights relating to the audit report are exhausted;28980

       (3) File reports as required by the department;28981

       (4) Open all records relating to the costs of its services28982
for inspection and audit by the department;28983

       (5) Open its premises for inspection by the department, the28984
department of health, and any other state or local authority28985
having authority to inspect;28986

       (6) Supply to the department such information as it requires28987
concerning the facility's services to residents who are or are28988
eligible to be medicaid recipients;28989

       (7) Comply with section 5111.315164.033 of the Revised Code.28990

       The provider agreement may contain other provisions that are28991
consistent with law and considered necessary by the department.28992

       A provider agreement shall be effective for no longer than28993
twelve months, except that if federal statute or regulations28994
authorize a longer term, it may be effective for a longer term so28995
authorized. A provider agreement may be renewed only if the28996
facility is certified by the department of health for28997
participation in the medicaid program.28998

       The department of job and family serviceshealth care 28999
administration, in accordance with rules adopted under section 29000
5111.025163.15 of the Revised Code, may elect not to enter into, 29001
not to renew, or to terminate a provider agreement when the 29002
department determines that such an agreement would not be in the 29003
best interests of medicaid recipients or of the state.29004

       Sec. 5111.223.        Sec. 5164.031. The operator of a nursing facility or 29005
intermediate care facility for the mentally retarded may enter 29006
into provider agreements for more than one nursing facility or 29007
intermediate care facility for the mentally retarded.29008

       Sec. 5111.30.        Sec. 5164.032.  The department of job and family 29009
serviceshealth care administration shall terminate the provider29010
agreement with a provider that does not comply with the 29011
requirements of section 3721.071 of the Revised Code for the 29012
installation of fire extinguishing and fire alarm systems.29013

       Sec. 5111.31.        Sec. 5164.033.  (A) Every provider agreement with the 29014
provider of a nursing facility or intermediate care facility for 29015
the mentally retarded shall:29016

       (1) Prohibit the provider from failing or refusing to retain 29017
as a patient any person because the person is, becomes, or may, as 29018
a patient in the facility, become a medicaid recipient. For the 29019
purposes of this division, a medicaid recipient who is a patient 29020
in a facility shall be considered a patient in the facility during 29021
any hospital stays totaling less than twenty-five days during any29022
twelve-month period. Recipients who have been identified by the29023
department of job and family serviceshealth care administration29024
or its designee as requiring the level of care of an intermediate 29025
care facility for the mentally retarded shall not be subject to a 29026
maximum period of absences during which they are considered 29027
patients if prior authorization of the department for visits with 29028
relatives and friends and participation in therapeutic programs 29029
is obtained under rules adopted under section 5111.025163.15 of 29030
the Revised Code.29031

       (2) Except as provided by division (B)(1) of this section, 29032
include any part of the facility that meets standards for 29033
certification of compliance with federal and state laws and rules 29034
for participation in the medicaid program.29035

       (3) Prohibit the provider from discriminating against any29036
patient on the basis of race, color, sex, creed, or national29037
origin.29038

       (4) Except as otherwise prohibited under section 5111.5529039
5164.71 of the Revised Code, prohibit the provider from failing 29040
or refusing to accept a patient because the patient is, becomes,29041
or may, as a patient in the facility, become a medicaid recipient 29042
if less than eighty per cent of the patients in the facility are 29043
medicaid recipients.29044

       (B)(1) Except as provided by division (B)(2) of this section, 29045
the following are not required to be included in a provider 29046
agreement unless otherwise required by federal law:29047

        (a) Beds added during the period beginning July 1, 1987, and 29048
ending July 1, 1993, to a nursing home licensed under Chapter 29049
3721. of the Revised Code;29050

        (b) Beds in an intermediate care facility for the mentally 29051
retarded that are designated for respite care under a medicaid 29052
waiver component operated pursuant to a waiver sought under 29053
section 5111.875163.65 of the Revised Code.29054

        (2) If a provider chooses to include a bed specified in 29055
division (B)(1)(a) of this section in a provider agreement, the 29056
bed may not be removed from the provider agreement unless the 29057
provider withdraws the facility in which the bed is located from 29058
the medicaid program.29059

       (C) Nothing in this section shall bar a provider that is a 29060
religious organization operating a religious or denominational 29061
nursing facility or intermediate care facility for the mentally 29062
retarded from giving preference to persons of the same religion or 29063
denomination. Nothing in this section shall bar any provider from 29064
giving preference to persons with whom the provider has 29065
contracted to provide continuing care.29066

       (D) Nothing in this section shall bar the provider of a 29067
county home organized under Chapter 5155. of the Revised Code from 29068
admitting residents exclusively from the county in which the 29069
county home is located.29070

       (E) No provider of a nursing facility or intermediate care 29071
facility for the mentally retarded for which a provider agreement 29072
is in effect shall violate the provider contract obligations 29073
imposed under this section.29074

       (F) Nothing in divisions (A) and (C) of this section shall29075
bar a provider from retaining patients who have resided in the29076
provider's facility for not less than one year as private pay 29077
patients and who subsequently become medicaid recipients, but 29078
refusing to accept as a patient any person who is or may, as a 29079
patient in the facility, become a medicaid recipient, if all of 29080
the following apply:29081

       (1) The provider does not refuse to retain any patient who29082
has resided in the provider's facility for not less than one year 29083
as a private pay patient because the patient becomes a medicaid 29084
recipient, except as necessary to comply with division (F)(2) of 29085
this section;29086

       (2) The number of medicaid recipients retained under this29087
division does not at any time exceed ten per cent of all the29088
patients in the facility;29089

       (3) On July 1, 1980, all the patients in the facility were29090
private pay patients.29091

       Sec. 5111.32.        Sec. 5164.034.  Any patient has a cause of action 29092
against the provider of a nursing facility or intermediate care 29093
facility for the mentally retarded for breach of the provider29094
agreement obligations or other duties imposed by section 5111.3129095
5164.033 of the Revised Code. The action may be commenced by the 29096
patient, or on the patient's behalf by the patient's sponsor or a 29097
residents' rights advocate, as either is defined under section29098
3721.10 of the Revised Code, by the filing of a civil action in29099
the court of common pleas of the county in which the facility is 29100
located, or in the court of common pleas of Franklin county.29101

       If the court finds that a breach of the provider agreement29102
obligations imposed by section 5111.315164.033 of the Revised 29103
Code has occurred, the court may enjoin the provider from engaging 29104
in the practice, order such affirmative relief as may be29105
necessary, and award to the patient and a person or public agency29106
that brings an action on behalf of a patient actual damages, 29107
costs, and reasonable attorney's fees.29108

       Sec. 5111.23.        Sec. 5164.05.  (A) The department of job and family29109
serviceshealth care administration shall pay a provider for each 29110
of the provider's eligible intermediate care facilities for the 29111
mentally retarded a per resident per day rate for direct care 29112
costs established prospectively for each facility. The department29113
shall establish each facility's rate for direct care costs29114
quarterly.29115

       (B) Each facility's rate for direct care costs shall be based 29116
on the facility's cost per case-mix unit, subject to the maximum 29117
costs per case-mix unit established under division (B)(2) of this 29118
section, from the calendar year preceding the fiscal year in which 29119
the rate is paid. To determine the rate, the department shall do 29120
all of the following:29121

       (1) Determine each facility's cost per case-mix unit for the 29122
calendar year preceding the fiscal year in which the rate will be 29123
paid by dividing the facility's desk-reviewed, actual, allowable, 29124
per diem direct care costs for that year by its average case-mix 29125
score determined under section 5111.2325164.051 of the Revised 29126
Code for the same calendar year.29127

       (2)(a) Set the maximum cost per case-mix unit for each peer29128
group of intermediate care facilities for the mentally retarded29129
with more than eight beds specified in rules adopted under29130
division (E) of this section at a percentage above the cost per29131
case-mix unit of the facility in the group that has the group's29132
median medicaid inpatient day for the calendar year preceding the 29133
fiscal year in which the rate will be paid, as calculated under 29134
division (B)(1) of this section, that is no less than the29135
percentage calculated under division (D)(2) of this section.29136

       (b) Set the maximum cost per case-mix unit for each peer29137
group of intermediate care facilities for the mentally retarded29138
with eight or fewer beds specified in rules adopted under division 29139
(E) of this section at a percentage above the cost per case-mix 29140
unit of the facility in the group that has the group's median 29141
medicaid inpatient day for the calendar year preceding the fiscal 29142
year in which the rate will be paid, as calculated under division 29143
(B)(1) of this section, that is no less than the percentage 29144
calculated under division (D)(3) of this section.29145

       (c) In calculating the maximum cost per case-mix unit under 29146
divisions (B)(2)(a) toand (b) of this section for each peer 29147
group, the department shall exclude from its calculations the cost 29148
per case-mix unit of any facility in the group that participated 29149
in the medicaid program under the same operator for less than 29150
twelve months during the calendar year preceding the fiscal year 29151
in which the rate will be paid.29152

       (3) Estimate the rate of inflation for the eighteen-month29153
period beginning on the first day of July of the calendar year29154
preceding the fiscal year in which the rate will be paid and29155
ending on the thirty-first day of December of the fiscal year in29156
which the rate will be paid, using the employment cost index for29157
total compensation, health services component, published by the29158
United States bureau of labor statistics. If the estimated29159
inflation rate for the eighteen-month period is different from the 29160
actual inflation rate for that period, as measured using the same 29161
index, the difference shall be added to or subtracted from the 29162
inflation rate estimated under division (B)(3) of this section for 29163
the following fiscal year.29164

       (4) The department shall not recalculate a maximum cost per 29165
case-mix unit under division (B)(2) of this section or a 29166
percentage under division (D) of this section based on additional 29167
information that it receives after the maximum costs per case-mix 29168
unit or percentages are set. The department shall recalculate a 29169
maximum cost per case-mix units or percentage only if it made an 29170
error in computing the maximum cost per case-mix unit or 29171
percentage based on information available at the time of the 29172
original calculation.29173

       (C) Each facility's rate for direct care costs shall be29174
determined as follows for each calendar quarter within a fiscal29175
year:29176

       (1) Multiply the lesser of the following by the facility's29177
average case-mix score determined under section 5111.2325164.05129178
of the Revised Code for the calendar quarter that preceded the29179
immediately preceding calendar quarter:29180

       (a) The facility's cost per case-mix unit for the calendar29181
year preceding the fiscal year in which the rate will be paid, as29182
determined under division (B)(1) of this section;29183

       (b) The maximum cost per case-mix unit established for the 29184
fiscal year in which the rate will be paid for the facility's peer 29185
group under division (B)(2) of this section;29186

       (2) Adjust the product determined under division (C)(1) of 29187
this section by the inflation rate estimated under division (B)(3) 29188
of this section.29189

       (D)(1) The department shall calculate the percentage above29190
the median cost per case-mix unit determined under division (B)(1) 29191
of this section for the facility that has the median medicaid 29192
inpatient day for calendar year 1992 for all intermediate care 29193
facilities for the mentally retarded with more than eight beds 29194
that would result in payment of all desk-reviewed, actual, 29195
allowable direct care costs for eighty and one-half per cent of 29196
the medicaid inpatient days for such facilities for calendar year 29197
1992.29198

       (2) The department shall calculate the percentage above the 29199
median cost per case-mix unit determined under division (B)(1) of 29200
this section for the facility that has the median medicaid 29201
inpatient day for calendar year 1992 for all intermediate care 29202
facilities for the mentally retarded with eight or fewer beds that 29203
would result in payment of all desk-reviewed, actual, allowable 29204
direct care costs for eighty and one-half per cent of the medicaid 29205
inpatient days for such facilities for calendar year 1992.29206

       (E) The director of job and family serviceshealth care 29207
administration shall adopt rules under section 5111.025163.15 of 29208
the Revised Code that specify peer groups of intermediate care 29209
facilities for the mentally retarded with more than eight beds and 29210
intermediate care facilities for the mentally retarded with eight 29211
or fewer beds, based on findings of significant per diem direct 29212
care cost differences due to geography and facility bed-size. The 29213
rules also may specify peer groups based on findings of 29214
significant per diem direct care cost differences due to other 29215
factors which may include case-mix.29216

       (F) The department, in accordance with division (D)(C) of29217
section 5111.2325164.051 of the Revised Code and rules adopted 29218
under division (E)(D) of that section, may assign case-mix scores 29219
or costs per case-mix unit if a provider fails to submit 29220
assessment data necessary to calculate an intermediate care 29221
facility for the mentally retarded's case-mix score in accordance 29222
with that section.29223

       Sec. 5164.051.  (A) The department of health care 29224
administration shall determine case-mix scores for intermediate 29225
care facilities for the mentally retarded using data for each 29226
resident, regardless of payment source, from a resident assessment 29227
instrument and grouper methodology prescribed in rules adopted 29228
under section 5163.15 of the Revised Code and expressed in 29229
case-mix values established by the department in those rules.29230

       (B) Each calendar quarter, each provider of an intermediate 29231
care facility for the mentally retarded shall compile complete 29232
assessment data, from the resident assessment instrument specified 29233
in rules authorized by division (A) of this section, for each 29234
resident of each of the provider's intermediate care facilities 29235
for the mentally retarded, regardless of payment source, who was 29236
in the facility or on hospital or therapeutic leave from the 29237
facility on the last day of the quarter. Providers shall submit 29238
the data to the department of health care administration. The data 29239
shall be submitted not later than fifteen days after the end of 29240
the calendar quarter for which the data is compiled.29241

       Except as provided in division (C) of this section, the 29242
department, after the end of each calendar year, shall calculate 29243
an annual average case-mix score for each intermediate care 29244
facility for the mentally retarded using the facility's quarterly 29245
case-mix scores for that calendar year. The department shall make 29246
the calculations pursuant to procedures specified in rules adopted 29247
under section 5163.15 of the Revised Code.29248

       (C)(1) If a provider of an intermediate care facility for the 29249
mentally retarded does not timely submit information for a 29250
calendar quarter necessary to calculate the facility's case-mix 29251
score, or submits incomplete or inaccurate information for a 29252
calendar quarter, the department may assign the facility a 29253
quarterly average case-mix score that is five per cent less than 29254
the facility's quarterly average case-mix score for the preceding 29255
calendar quarter. If the facility was subject to an exception 29256
review under division (C) of section 5164.38 of the Revised Code 29257
for the preceding calendar quarter, the department may assign a 29258
quarterly average case-mix score that is five per cent less than 29259
the score determined by the exception review. If the facility was 29260
assigned a quarterly average case-mix score for the preceding 29261
quarter, the department may assign a quarterly average case-mix 29262
score that is five per cent less than that score assigned for the 29263
preceding quarter.29264

       The department may use a quarterly average case-mix score 29265
assigned under division (C)(1) of this section, instead of a 29266
quarterly average case-mix score calculated based on the 29267
provider's submitted information, to calculate the facility's rate 29268
for direct care costs being established under section 5164.05 of 29269
the Revised Code for one or more months, as specified in rules 29270
authorized by division (D) of this section, of the quarter for 29271
which the rate established under section 5164.05 of the Revised 29272
Code will be paid.29273

       Before taking action under division (C)(1) of this section, 29274
the department shall permit the provider a reasonable period of 29275
time, specified in rules authorized by division (D) of this 29276
section, to correct the information. The department shall not 29277
assign a quarterly average case-mix score due to late submission 29278
of corrections to assessment information unless the provider fails 29279
to submit corrected information prior to the eighty-first day 29280
after the end of the calendar quarter to which the information 29281
pertains.29282

       (2) If a provider is paid a rate for an intermediate care 29283
facility for the mentally retarded calculated using a quarterly 29284
average case-mix score assigned under division (C)(1) of this 29285
section for more than six months in a calendar year, the 29286
department may assign the facility a cost per case-mix unit that 29287
is five per cent less than the facility's actual or assigned cost 29288
per case-mix unit for the preceding calendar year. The department 29289
may use the assigned cost per case-mix unit, instead of 29290
calculating the facility's actual cost per case-mix unit in 29291
accordance with section 5164.05 of the Revised Code, to establish 29292
the facility's rate for direct care costs for the following fiscal 29293
year.29294

       (3) The department shall take action under division (C)(1) or 29295
(2) of this section only in accordance with rules authorized by 29296
division (D) of this section. The department shall not take an 29297
action that affects rates for prior payment periods except in 29298
accordance with sections 5164.38 and 5164.39 of the Revised Code.29299

       (D) The director shall adopt rules under section 5163.15 of 29300
the Revised Code that do all of the following:29301

       (1) Specify the medium or media through which the completed 29302
assessment data shall be submitted;29303

       (2) Establish procedures under which the assessment data 29304
shall be reviewed for accuracy and providers shall be notified of 29305
any data that requires correction;29306

       (3) Establish procedures for providers to correct assessment 29307
data and specify a reasonable period of time by which providers 29308
shall submit the corrections;29309

       (4) Specify when and how the department will assign case-mix 29310
scores or costs per case-mix unit under division (C) of this 29311
section if information necessary to calculate the facility's 29312
case-mix score is not provided or corrected in accordance with the 29313
procedures established by the rules. Notwithstanding any other 29314
provision of sections 5164.01 to 5164.47 of the Revised Code, the 29315
rules also may provide for excluding case-mix scores assigned 29316
under division (C) of this section from calculation of an 29317
intermediate care facility for the mentally retarded's annual 29318
average case-mix score and the maximum cost per case-mix unit for 29319
the facility's peer group.29320

       Sec. 5111.235.        Sec. 5164.06.  The department of job and family 29321
serviceshealth care administration shall pay a provider for each 29322
of the provider's eligible intermediate care facilities for the 29323
mentally retarded a per resident per day rate for other protected 29324
costs established prospectively each fiscal year for each 29325
facility. The rate for each facility shall be the facility's 29326
desk-reviewed, actual, allowable, per diem other protected costs29327
from the calendar year preceding the fiscal year in which the rate 29328
will be paid, all adjusted for the estimated inflation rate for 29329
the eighteen-month period beginning on the first day of July of 29330
the calendar year preceding the fiscal year in which the rate will 29331
be paid and ending on the thirty-first day of December of that 29332
fiscal year. The department shall estimate inflation using the 29333
consumer price index for all urban consumers for nonprescription 29334
drugs and medical supplies, as published by the United States 29335
bureau of labor statistics. If the estimated inflation rate for 29336
the eighteen-month period is different from the actual inflation 29337
rate for that period, the difference shall be added to or 29338
subtracted from the inflation rate estimated for the following 29339
year.29340

       Sec. 5111.241.        Sec. 5164.07.  (A) The department of job and family 29341
serviceshealth care administration shall pay a provider for each 29342
of the provider's eligible intermediate care facilities for the 29343
mentally retarded a per resident per day rate for indirect care 29344
costs established prospectively each fiscal year for each 29345
facility. The rate for each intermediate care facility for the 29346
mentally retarded shall be the sum of the following, but shall not 29347
exceed the maximum rate established for the facility's peer group 29348
under division (B) of this section:29349

       (1) The facility's desk-reviewed, actual, allowable, per diem 29350
indirect care costs from the calendar year preceding the fiscal 29351
year in which the rate will be paid, adjusted for the inflation 29352
rate estimated under division (C)(1) of this section;29353

       (2) An efficiency incentive in the following amount:29354

       (a) For fiscal years ending in even-numbered calendar years:29355

       (i) In the case of intermediate care facilities for the29356
mentally retarded with more than eight beds, seven and one-tenth29357
per cent of the maximum rate established for the facility's peer29358
group under division (B) of this section;29359

       (ii) In the case of intermediate care facilities for the29360
mentally retarded with eight or fewer beds, seven per cent of the29361
maximum rate established for the facility's peer group under29362
division (B) of this section;29363

       (b) For fiscal years ending in odd-numbered calendar years, 29364
the amount calculated for the preceding fiscal year under division 29365
(A)(2)(a) of this section.29366

       (B)(1) The maximum rate for indirect care costs for each peer 29367
group of intermediate care facilities for the mentally retarded 29368
with more than eight beds specified in rules adopted under 29369
division (D) of this section shall be determined as follows:29370

       (a) For fiscal years ending in even-numbered calendar years, 29371
the maximum rate for each peer group shall be the rate that is no29372
less than twelve and four-tenths per cent above the median29373
desk-reviewed, actual, allowable, per diem indirect care cost for29374
all intermediate care facilities for the mentally retarded with29375
more than eight beds in the group, excluding facilities in the29376
group whose indirect care costs for that period are more than29377
three standard deviations from the mean desk-reviewed, actual,29378
allowable, per diem indirect care cost for all intermediate care29379
facilities for the mentally retarded with more than eight beds,29380
for the calendar year preceding the fiscal year in which the rate29381
will be paid, adjusted by the inflation rate estimated under29382
division (C)(1) of this section.29383

       (b) For fiscal years ending in odd-numbered calendar years, 29384
the maximum rate for each peer group is the group's maximum rate 29385
for the previous fiscal year, adjusted for the inflation rate 29386
estimated under division (C)(2) of this section.29387

       (2) The maximum rate for indirect care costs for each peer29388
group of intermediate care facilities for the mentally retarded29389
with eight or fewer beds specified in rules adopted under division 29390
(D) of this section shall be determined as follows:29391

       (a) For fiscal years ending in even-numbered calendar years, 29392
the maximum rate for each peer group shall be the rate that is no 29393
less than ten and three-tenths per cent above the median 29394
desk-reviewed, actual, allowable, per diem indirect care cost for 29395
all intermediate care facilities for the mentally retarded with 29396
eight or fewer beds in the group, excluding facilities in the 29397
group whose indirect care costs are more than three standard 29398
deviations from the mean desk-reviewed, actual, allowable, per 29399
diem indirect care cost for all intermediate care facilities for 29400
the mentally retarded with eight or fewer beds, for the calendar 29401
year preceding the fiscal year in which the rate will be paid, 29402
adjusted by the inflation rate estimated under division (C)(1) of 29403
this section.29404

       (b) For fiscal years that end in odd-numbered calendar years, 29405
the maximum rate for each peer group is the group's maximum rate 29406
for the previous fiscal year, adjusted for the inflation rate 29407
estimated under division (C)(2) of this section.29408

       (3) The department shall not recalculate a maximum rate for 29409
indirect care costs under division (B)(1) or (2) of this section 29410
based on additional information that it receives after the maximum 29411
rate is set. The department shall recalculate the maximum rate for 29412
indirect care costs only if it made an error in computing the 29413
maximum rate based on the information available at the time of the 29414
original calculation.29415

       (C)(1) When adjusting rates for inflation under divisions29416
(A)(1), (B)(1)(a), and (B)(2)(a) of this section, the department29417
shall estimate the rate of inflation for the eighteen-month period 29418
beginning on the first day of July of the calendar year preceding 29419
the fiscal year in which the rate will be paid and ending on the 29420
thirty-first day of December of the fiscal year in which the rate 29421
will be paid, using the consumer price index for all items for all 29422
urban consumers for the north central region, published by the 29423
United States bureau of labor statistics.29424

       (2) When adjusting rates for inflation under divisions29425
(B)(1)(b) and (B)(2)(b) of this section, the department shall29426
estimate the rate of inflation for the twelve-month period29427
beginning on the first day of January of the fiscal year preceding 29428
the fiscal year in which the rate will be paid and ending on the 29429
thirty-first day of December of the fiscal year in which the rate 29430
will be paid, using the consumer price index for all items for all 29431
urban consumers for the north central region, published by the 29432
United States bureau of labor statistics.29433

       (3) If an inflation rate estimated under division (C)(1) or 29434
(2) of this section is different from the actual inflation rate 29435
for the relevant time period, as measured using the same index, 29436
the difference shall be added to or subtracted from the inflation 29437
rate estimated pursuant to this division for the following fiscal 29438
year.29439

       (D) The director of job and family serviceshealth care 29440
administration shall adopt rules under section 5111.025163.15 of 29441
the Revised Code that specify peer groups of intermediate care 29442
facilities for the mentally retarded with more than eight beds, 29443
and peer groups of intermediate care facilities for the mentally 29444
retarded with eight or fewer beds, based on findings of 29445
significant per diem indirect care cost differences due to 29446
geography and facility bed-size. The rules also may specify peer 29447
groups based on findings of significant per diem indirect care 29448
cost differences due to other factors, including case-mix.29449

       Sec. 5111.251.        Sec. 5164.08.  (A) The department of job and family29450
serviceshealth care administration shall pay a provider for each 29451
of the provider's eligible intermediate care facilities for the 29452
mentally retarded for its reasonable capital costs, a per resident 29453
per day rate established prospectively each fiscal year for each29454
intermediate care facility for the mentally retarded. Except as29455
otherwise provided in sections 5111.205164.01 to 5111.335164.4129456
of the Revised Code, the rate shall be based on the facility's 29457
capital costs for the calendar year preceding the fiscal year in 29458
which the rate will be paid. The rate shall equal the sum of the 29459
following:29460

       (1) The facility's desk-reviewed, actual, allowable, per diem 29461
cost of ownership for the preceding cost reporting period, limited 29462
as provided in divisions (C) and (F) of this section;29463

       (2) Any efficiency incentive determined under division (B) of 29464
this section;29465

       (3) Any amounts for renovations determined under division (D) 29466
of this section;29467

       (4) Any amounts for return on equity determined under29468
division (I) of this section.29469

       Buildings shall be depreciated using the straight line method29470
over forty years or over a different period approved by the29471
department. Components and equipment shall be depreciated using29472
the straight line method over a period designated by the director29473
of job and family serviceshealth care administration in rules 29474
adopted under section 5111.025163.15 of the Revised Code, 29475
consistent with the guidelines of the American hospital 29476
association, or over a different period approved by the department 29477
of job and family serviceshealth care administration. Any rules 29478
authorized by this division that specify useful lives of29479
buildings, components, or equipment apply only to assets acquired29480
on or after July 1, 1993. Depreciation for costs paid or29481
reimbursed by any government agency shall not be included in costs29482
of ownership or renovation unless that part of the payment under29483
sections 5111.205164.01 to 5111.335164.41 of the Revised Code is29484
used to reimburse the government agency.29485

       (B) The department of job and family serviceshealth care 29486
administration shall pay to a provider for each of the provider's 29487
eligible intermediate care facilities for the mentally retarded an29488
efficiency incentive equal to fifty per cent of the difference29489
between any desk-reviewed, actual, allowable cost of ownership and29490
the applicable limit on cost of ownership payments under division29491
(C) of this section. For purposes of computing the efficiency29492
incentive, depreciation for costs paid or reimbursed by any29493
government agency shall be considered as a cost of ownership, and29494
the applicable limit under division (C) of this section shall29495
apply both to facilities with more than eight beds and facilities29496
with eight or fewer beds. The efficiency incentive paid to a 29497
provider for a facility with eight or fewer beds shall not exceed29498
three dollars per patient day, adjusted annually for the inflation 29499
rate for the twelve-month period beginning on the first day of 29500
July of the calendar year preceding the calendar year that29501
precedes the fiscal year for which the efficiency incentive is29502
determined and ending on the thirtieth day of the following June,29503
using the consumer price index for shelter costs for all urban29504
consumers for the north central region, as published by the United 29505
States bureau of labor statistics.29506

       (C) Cost of ownership payments for intermediate care29507
facilities for the mentally retarded with more than eight beds29508
shall not exceed the following limits:29509

       (1) For facilities with dates of licensure prior to January29510
1, l958, not exceeding two dollars and fifty cents per patient29511
day;29512

       (2) For facilities with dates of licensure after December 31, 29513
l957, but prior to January 1, l968, not exceeding:29514

       (a) Three dollars and fifty cents per patient day if the cost 29515
of construction was three thousand five hundred dollars or more 29516
per bed;29517

       (b) Two dollars and fifty cents per patient day if the cost29518
of construction was less than three thousand five hundred dollars29519
per bed.29520

       (3) For facilities with dates of licensure after December 31, 29521
l967, but prior to January 1, l976, not exceeding:29522

       (a) Four dollars and fifty cents per patient day if the cost29523
of construction was five thousand one hundred fifty dollars or29524
more per bed;29525

       (b) Three dollars and fifty cents per patient day if the cost 29526
of construction was less than five thousand one hundred fifty29527
dollars per bed, but exceeds three thousand five hundred dollars29528
per bed;29529

       (c) Two dollars and fifty cents per patient day if the cost29530
of construction was three thousand five hundred dollars or less29531
per bed.29532

       (4) For facilities with dates of licensure after December 31, 29533
l975, but prior to January 1, l979, not exceeding:29534

       (a) Five dollars and fifty cents per patient day if the cost29535
of construction was six thousand eight hundred dollars or more per29536
bed;29537

       (b) Four dollars and fifty cents per patient day if the cost29538
of construction was less than six thousand eight hundred dollars29539
per bed but exceeds five thousand one hundred fifty dollars per29540
bed;29541

       (c) Three dollars and fifty cents per patient day if the cost 29542
of construction was five thousand one hundred fifty dollars or 29543
less per bed, but exceeds three thousand five hundred dollars per 29544
bed;29545

       (d) Two dollars and fifty cents per patient day if the cost29546
of construction was three thousand five hundred dollars or less29547
per bed.29548

       (5) For facilities with dates of licensure after December 31, 29549
l978, but prior to January 1, l980, not exceeding:29550

       (a) Six dollars per patient day if the cost of construction29551
was seven thousand six hundred twenty-five dollars or more per29552
bed;29553

       (b) Five dollars and fifty cents per patient day if the cost29554
of construction was less than seven thousand six hundred29555
twenty-five dollars per bed but exceeds six thousand eight hundred29556
dollars per bed;29557

       (c) Four dollars and fifty cents per patient day if the cost29558
of construction was six thousand eight hundred dollars or less per29559
bed but exceeds five thousand one hundred fifty dollars per bed;29560

       (d) Three dollars and fifty cents per patient day if the cost 29561
of construction was five thousand one hundred fifty dollars or 29562
less but exceeds three thousand five hundred dollars per bed;29563

       (e) Two dollars and fifty cents per patient day if the cost29564
of construction was three thousand five hundred dollars or less29565
per bed.29566

       (6) For facilities with dates of licensure after December 31, 29567
1979, but prior to January 1, 1981, not exceeding:29568

       (a) Twelve dollars per patient day if the beds were29569
originally licensed as residential facility beds by the department29570
of mental retardation and developmental disabilities;29571

       (b) Six dollars per patient day if the beds were originally29572
licensed as nursing home beds by the department of health.29573

       (7) For facilities with dates of licensure after December 31,29574
1980, but prior to January 1, 1982, not exceeding:29575

       (a) Twelve dollars per patient day if the beds were29576
originally licensed as residential facility beds by the department29577
of mental retardation and developmental disabilities;29578

       (b) Six dollars and forty-five cents per patient day if the29579
beds were originally licensed as nursing home beds by the29580
department of health.29581

       (8) For facilities with dates of licensure after December 31,29582
1981, but prior to January 1, 1983, not exceeding:29583

       (a) Twelve dollars per patient day if the beds were29584
originally licensed as residential facility beds by the department29585
of mental retardation and developmental disabilities;29586

       (b) Six dollars and seventy-nine cents per patient day if the 29587
beds were originally licensed as nursing home beds by the29588
department of health.29589

       (9) For facilities with dates of licensure after December 31,29590
1982, but prior to January 1, 1984, not exceeding:29591

       (a) Twelve dollars per patient day if the beds were29592
originally licensed as residential facility beds by the department29593
of mental retardation and developmental disabilities;29594

       (b) Seven dollars and nine cents per patient day if the beds29595
were originally licensed as nursing home beds by the department of29596
health.29597

       (10) For facilities with dates of licensure after December29598
31, 1983, but prior to January 1, 1985, not exceeding:29599

       (a) Twelve dollars and twenty-four cents per patient day if29600
the beds were originally licensed as residential facility beds by29601
the department of mental retardation and developmental29602
disabilities;29603

       (b) Seven dollars and twenty-three cents per patient day if29604
the beds were originally licensed as nursing home beds by the29605
department of health.29606

       (11) For facilities with dates of licensure after December29607
31, 1984, but prior to January 1, 1986, not exceeding:29608

       (a) Twelve dollars and fifty-three cents per patient day if29609
the beds were originally licensed as residential facility beds by29610
the department of mental retardation and developmental29611
disabilities;29612

       (b) Seven dollars and forty cents per patient day if the beds 29613
were originally licensed as nursing home beds by the department of 29614
health.29615

       (12) For facilities with dates of licensure after December29616
31, 1985, but prior to January 1, 1987, not exceeding:29617

       (a) Twelve dollars and seventy cents per patient day if the29618
beds were originally licensed as residential facility beds by the29619
department of mental retardation and developmental disabilities;29620

       (b) Seven dollars and fifty cents per patient day if the beds 29621
were originally licensed as nursing home beds by the department of 29622
health.29623

       (13) For facilities with dates of licensure after December29624
31, 1986, but prior to January 1, 1988, not exceeding:29625

       (a) Twelve dollars and ninety-nine cents per patient day if29626
the beds were originally licensed as residential facility beds by29627
the department of mental retardation and developmental29628
disabilities;29629

       (b) Seven dollars and sixty-seven cents per patient day if29630
the beds were originally licensed as nursing home beds by the29631
department of health.29632

       (14) For facilities with dates of licensure after December29633
31, 1987, but prior to January 1, 1989, not exceeding thirteen29634
dollars and twenty-six cents per patient day;29635

       (15) For facilities with dates of licensure after December29636
31, 1988, but prior to January 1, 1990, not exceeding thirteen29637
dollars and forty-six cents per patient day;29638

       (16) For facilities with dates of licensure after December29639
31, 1989, but prior to January 1, 1991, not exceeding thirteen29640
dollars and sixty cents per patient day;29641

       (17) For facilities with dates of licensure after December29642
31, 1990, but prior to January 1, 1992, not exceeding thirteen29643
dollars and forty-nine cents per patient day;29644

       (18) For facilities with dates of licensure after December29645
31, 1991, but prior to January 1, 1993, not exceeding thirteen29646
dollars and sixty-seven cents per patient day;29647

       (19) For facilities with dates of licensure after December29648
31, 1992, not exceeding fourteen dollars and twenty-eight cents29649
per patient day.29650

       (D) Beginning January 1, 1981, regardless of the original29651
date of licensure, the department of job and family services29652
health care administration shall pay a rate for the per diem 29653
capitalized costs of renovations to intermediate care facilities 29654
for the mentally retarded made after January 1, l981, not 29655
exceeding six dollars per patient day using 1980 as the base year 29656
and adjusting the amount annually until June 30, 1993, for29657
fluctuations in construction costs calculated by the department29658
using the "Dodge building cost indexes, northeastern and north29659
central states," published by Marshall and Swift. The payment29660
provided for in this division is the only payment that shall be29661
made for the capitalized costs of a nonextensive renovation of an29662
intermediate care facility for the mentally retarded. 29663
Nonextensive renovation costs shall not be included in cost of29664
ownership, and a nonextensive renovation shall not affect the date 29665
of licensure for purposes of division (C) of this section. This 29666
division applies to nonextensive renovations regardless of whether 29667
they are made by an owner or a lessee. If the tenancy of a lessee 29668
that has made renovations ends before the depreciation expense for 29669
the renovation costs has been fully reported, the former lessee 29670
shall not report the undepreciated balance as an expense.29671

       For a nonextensive renovation to qualify for payment under29672
this division, both of the following conditions must be met:29673

       (1) At least five years have elapsed since the date of29674
licensure or date of an extensive renovation of the portion of the29675
facility that is proposed to be renovated, except that this29676
condition does not apply if the renovation is necessary to meet29677
the requirements of federal, state, or local statutes, ordinances,29678
rules, or policies.29679

       (2) The provider has obtained prior approval from the29680
department of job and family serviceshealth care administration. 29681
The provider shall submit a plan that describes in detail the 29682
changes in capital assets to be accomplished by means of the 29683
renovation and the timetable for completing the project. The time 29684
for completion of the project shall be no more than eighteen 29685
months after the renovation begins. The director of job and family 29686
serviceshealth care administration shall adopt rules under 29687
section 5111.025163.15 of the Revised Code that specify criteria 29688
and procedures for prior approval of renovation projects. No 29689
provider shall separate a project with the intent to evade the29690
characterization of the project as a renovation or as an extensive29691
renovation. No provider shall increase the scope of a project29692
after it is approved by the department of job and family services29693
health care administration unless the increase in scope is 29694
approved by the department.29695

       (E) The amounts specified in divisions (C) and (D) of this29696
section shall be adjusted beginning July 1, 1993, for the29697
estimated inflation for the twelve-month period beginning on the29698
first day of July of the calendar year preceding the calendar year29699
that precedes the fiscal year for which rate will be paid and29700
ending on the thirtieth day of the following June, using the29701
consumer price index for shelter costs for all urban consumers for29702
the north central region, as published by the United States bureau29703
of labor statistics.29704

       (F)(1) For facilities of eight or fewer beds that have dates29705
of licensure or have been granted project authorization by the29706
department of mental retardation and developmental disabilities29707
before July 1, 1993, and for facilities of eight or fewer beds29708
that have dates of licensure or have been granted project29709
authorization after that date if the providers of the facilities29710
demonstrate that they made substantial commitments of funds on or29711
before that date, cost of ownership shall not exceed eighteen29712
dollars and thirty cents per resident per day. The eighteen-dollar 29713
and thirty-cent amount shall be increased by the change in the 29714
"Dodge building cost indexes, northeastern and north central 29715
states," published by Marshall and Swift, during the period 29716
beginning June 30, 1990, and ending July 1, 1993, and by the 29717
change in the consumer price index for shelter costs for all urban 29718
consumers for the north central region, as published by the United 29719
States bureau of labor statistics, annually thereafter.29720

       (2) For facilities with eight or fewer beds that have dates29721
of licensure or have been granted project authorization by the29722
department of mental retardation and developmental disabilities on29723
or after July 1, 1993, for which substantial commitments of funds29724
were not made before that date, cost of ownership payments shall29725
not exceed the applicable amount calculated under division (F)(1)29726
of this section, if the department of job and family services29727
health care administration gives prior approval for construction 29728
of the facility. If the department does not give prior approval, 29729
cost of ownership payments shall not exceed the amount specified 29730
in division (C) of this section.29731

       (3) Notwithstanding divisions (D) and (F)(1) and (2) of this29732
section, the total payment for cost of ownership, cost of29733
ownership efficiency incentive, and capitalized costs of29734
renovations for an intermediate care facility for the mentally29735
retarded with eight or fewer beds shall not exceed the sum of the29736
limitations specified in divisions (C) and (D) of this section.29737

       (G) Notwithstanding any provision of this section or section 29738
5111.2415164.07 of the Revised Code, the director of job and 29739
family serviceshealth care administration may adopt rules under 29740
section 5111.025163.15 of the Revised Code that provide for a 29741
calculation of a combined maximum payment limit for indirect care 29742
costs and cost of ownership for intermediate care facilities for 29743
the mentally retarded with eight or fewer beds.29744

       (H) After the date on which a transaction of sale is closed, 29745
the provider shall refund to the department the amount of excess 29746
depreciation paid to the provider for the facility by the 29747
department for each year the provider has operated the facility 29748
under a provider agreement and prorated according to the number of 29749
medicaid patient days for which the provider has received payment 29750
for the facility. For the purposes of this division, 29751
"depreciation paid to the provider for the facility" means the 29752
amount paid to the provider for the intermediate care facility for 29753
the mentally retarded for cost of ownership pursuant to this29754
section less any amount paid for interest costs. For the purposes29755
of this division, "excess depreciation" is the intermediate care29756
facility for the mentally retarded's depreciated basis, which is29757
the provider's cost less accumulated depreciation, subtracted from29758
the purchase price but not exceeding the amount of depreciation29759
paid to the provider for the facility.29760

       (I) The department of job and family serviceshealth care 29761
administration shall pay a provider for each of the provider's29762
eligible proprietary intermediate care facilities for the mentally29763
retarded a return on the facility's net equity computed at the29764
rate of one and one-half times the average of interest rates on29765
special issues of public debt obligations issued to the federal29766
hospital insurance trust fund for the cost reporting period. No29767
facility's return on net equity paid under this division shall29768
exceed one dollar per patient day.29769

       In calculating the rate for return on net equity, the29770
department shall use the greater of the facility's inpatient days29771
during the applicable cost reporting period or the number of29772
inpatient days the facility would have had during that period if29773
its occupancy rate had been ninety-five per cent.29774

       (J)(1) Except as provided in division (J)(2) of this section, 29775
if a provider leases or transfers an interest in a facility to 29776
another provider who is a related party, the related party's 29777
allowable cost of ownership shall include the lesser of the 29778
following:29779

       (a) The annual lease expense or actual cost of ownership,29780
whichever is applicable;29781

       (b) The reasonable cost to the lessor or provider making the29782
transfer.29783

       (2) If a provider leases or transfers an interest in a29784
facility to another provider who is a related party, regardless of29785
the date of the lease or transfer, the related party's allowable29786
cost of ownership shall include the annual lease expense or actual29787
cost of ownership, whichever is applicable, subject to the29788
limitations specified in divisions (B) to (I) of this section, if29789
all of the following conditions are met:29790

       (a) The related party is a relative of owner;29791

       (b) In the case of a lease, if the lessor retains any29792
ownership interest, it is, except as provided in division29793
(J)(2)(d)(ii) of this section, in only the real property and any29794
improvements on the real property;29795

       (c) In the case of a transfer, the provider making the29796
transfer retains, except as provided in division (J)(2)(d)(iv) of29797
this section, no ownership interest in the facility;29798

       (d) The department of job and family serviceshealth care 29799
administration determines that the lease or transfer is an arm's 29800
length transaction pursuant to rules adopted under section 5111.0229801
5163.15 of the Revised Code. The rules shall provide that a lease 29802
or transfer is an arm's length transaction if all of the 29803
following, as applicable, apply:29804

       (i) In the case of a lease, once the lease goes into effect,29805
the lessor has no direct or indirect interest in the lessee or,29806
except as provided in division (J)(2)(b) of this section, the29807
facility itself, including interest as an owner, officer,29808
director, employee, independent contractor, or consultant, but29809
excluding interest as a lessor.29810

       (ii) In the case of a lease, the lessor does not reacquire an29811
interest in the facility except through the exercise of a lessor's 29812
rights in the event of a default. If the lessor reacquires an 29813
interest in the facility in this manner, the department shall 29814
treat the facility as if the lease never occurred when the 29815
department calculates its reimbursement rates for capital costs.29816

       (iii) In the case of a transfer, once the transfer goes into29817
effect, the provider that made the transfer has no direct or29818
indirect interest in the provider that acquires the facility or29819
the facility itself, including interest as an owner, officer,29820
director, employee, independent contractor, or consultant, but29821
excluding interest as a creditor.29822

       (iv) In the case of a transfer, the provider that made the29823
transfer does not reacquire an interest in the facility except29824
through the exercise of a creditor's rights in the event of a29825
default. If the provider reacquires an interest in the facility in 29826
this manner, the department shall treat the facility as if the29827
transfer never occurred when the department calculates its29828
reimbursement rates for capital costs.29829

       (v) The lease or transfer satisfies any other criteria29830
specified in the rules.29831

       (e) Except in the case of hardship caused by a catastrophic29832
event, as determined by the department, or in the case of a lessor29833
or provider making the transfer who is at least sixty-five years29834
of age, not less than twenty years have elapsed since, for the29835
same facility, allowable cost of ownership was determined most29836
recently under this division.29837

       Sec. 5111.261.        Sec. 5164.10.  Except as otherwise provided in 29838
section 5111.2645164.372 of the Revised Code, the department of 29839
job and family serviceshealth care administration, in determining 29840
whether an intermediate care facility for the mentally retarded's 29841
direct care costs and indirect care costs are allowable, shall 29842
place no limit on specific categories of reasonable costs other 29843
than compensation of owners, compensation of relatives of owners, 29844
compensation of administrators and costs for resident meals that 29845
are prepared and consumed outside the facility.29846

       Compensation cost limits for owners and relatives of owners29847
shall be based on compensation costs for individuals who hold29848
comparable positions but who are not owners or relatives of29849
owners, as reported on facility cost reports. As used in this29850
section, "comparable position" means the position that is held by29851
the owner or the owner's relative, if that position is listed29852
separately on the cost report form, or if the position is not29853
listed separately, the group of positions that is listed on the29854
cost report form and that includes the position held by the owner29855
or the owner's relative. In the case of an owner or owner's29856
relative who serves the facility in a capacity such as corporate29857
officer, proprietor, or partner for which no comparable position29858
or group of positions is listed on the cost report form, the29859
compensation cost limit shall be based on civil service29860
equivalents and shall be specified in rules adopted under section 29861
5111.025163.15 of the Revised Code.29862

       Compensation cost limits for administrators shall be based on 29863
compensation costs for administrators who are not owners or29864
relatives of owners, as reported on facility cost reports.29865
Compensation cost limits for administrators of four or more29866
intermediate care facilities for the mentally retarded shall be29867
the same as the limits for administrators of intermediate care 29868
facilities for the mentally retarded with one hundred fifty or 29869
more beds.29870

       Sec. 5111.255.        Sec. 5164.12.  (A) The department of job and family 29871
serviceshealth care administration shall establish initial rates 29872
for an intermediate care facility for the mentally retarded with a 29873
first date of licensure that is on or after January 1, 1993, 29874
including a facility that replaces one or more existing 29875
facilities, or for an intermediate care facility for the mentally29876
retarded with a first date of licensure before that date that was29877
initially certified for the medicaid program on or after that 29878
date, in the following manner:29879

       (1) The rate for direct care costs shall be determined as29880
follows:29881

       (a) If there are no cost or resident assessment data as29882
necessary to calculate a rate under section 5111.235164.05 of the29883
Revised Code, the rate shall be the median cost per case-mix unit29884
calculated under division (B)(1) of that section for the relevant29885
peer group for the calendar year preceding the fiscal year in29886
which the rate will be paid, multiplied by the median annual 29887
average case-mix score for the peer group for that period and by 29888
the rate of inflation estimated under division (B)(3) of that 29889
section. This rate shall be recalculated to reflect the 29890
facility's actual quarterly average case-mix score, in accordance 29891
with that section, after it submits its first quarterly assessment 29892
data that qualifies for use in calculating a case-mix score in 29893
accordance with rules authorized by division (E)(D) of section 29894
5111.2325164.051 of the Revised Code. If the facility's first two 29895
quarterly submissions do not contain assessment data that 29896
qualifies for use in calculating a case-mix score, the department 29897
shall continue to calculate the rate using the median annual 29898
case-mix score for the peer group in lieu of an assigned quarterly 29899
case-mix score. The department shall assign a case-mix score or, 29900
if necessary, a cost per case-mix unit under division (D)(C) of 29901
section 5111.2325164.051 of the Revised Code for any subsequent 29902
submissions that do not contain assessment data that qualifies for 29903
use in calculating a case-mix score.29904

       (b) If the facility is a replacement facility and the29905
facility or facilities that are being replaced are in operation29906
immediately before the replacement facility opens, the rate shall29907
be the same as the rate for the replaced facility or facilities,29908
proportionate to the number of beds in each replaced facility. If 29909
one or more of the replaced facilities is not in operation29910
immediately before the replacement facility opens, its proportion29911
shall be determined under division (A)(1)(a) of this section.29912

       (2) The rate for other protected costs shall be one hundred 29913
fifteen per cent of the median rate for intermediate care 29914
facilities for the mentally retarded calculated for the fiscal 29915
year under section 5111.2355164.06 of the Revised Code.29916

       (3) The rate for indirect care costs shall be the applicable 29917
maximum rate for the facility's peer group as specified in 29918
division (B) of section 5111.2415164.07 of the Revised Code.29919

       (4) The rate for capital costs shall be determined under29920
section 5111.2515164.08 of the Revised Code using the greater of 29921
actual inpatient days or an imputed occupancy rate of eighty per 29922
cent.29923

       (B) The department shall adjust the rates established under 29924
division (A) of this section at both of the following times:29925

       (1) Effective the first day of July, to reflect new rate29926
calculations for all facilities under sections 5111.205164.01 to 29927
5111.335164.41 of the Revised Code;29928

       (2) Following the provider's submission of the facility's 29929
cost report under division (A)(1)(b) of section 5111.265164.37 of 29930
the Revised Code.29931

       The department shall pay the rate adjusted based on the cost 29932
report beginning the first day of the calendar quarter that begins 29933
more than ninety days after the department receives the cost 29934
report.29935

       Sec. 5111.291.        Sec. 5164.13.  Notwithstanding sections 5111.2029936
5164.01 to 5111.335164.41 of the Revised Code, the department of 29937
job and family serviceshealth care administration may compute the 29938
rate for intermediate care facilities for the mentally retarded 29939
operated by the department of mental retardation and developmental 29940
disabilities or the department of mental health according to the 29941
reasonable cost principles of Title XVIIIthe medicare program.29942

       Sec. 5111.211.        Sec. 5164.14.  (A) The department of mental 29943
retardation and developmental disabilities is responsible for the 29944
nonfederal share of claims submitted for services that are covered 29945
by the medicaid program and provided to an eligible medicaid 29946
recipient by an intermediate care facility for the mentally 29947
retarded if all of the following are the case:29948

       (1) The services are provided on or after July 1, 2003;29949

       (2) The facility receives initial certification by the 29950
director of health as an intermediate care facility for the 29951
mentally retarded on or after June 1, 2003;29952

       (3) The facility, or a portion of the facility, is licensed 29953
by the director of mental retardation and developmental 29954
disabilities as a residential facility under section 5123.19 of 29955
the Revised Code;29956

       (4) There is a valid provider agreement for the facility.29957

       (B) Each month, the department of job and family services29958
health care administration shall invoice the department of mental 29959
retardation and developmental disabilities by interagency transfer 29960
voucher for the claims for which the department of mental 29961
retardation and developmental disabilities is responsible pursuant 29962
to this section.29963

       Sec. 5111.222.        Sec. 5164.18.  (A) Except as otherwise provided by 29964
sections 5111.205164.01 to 5111.335164.41 of the Revised Code 29965
and by division (B) of this section, the payments that the 29966
department of job and family serviceshealth care administration29967
shall agree to make to the provider of a nursing facility pursuant 29968
to a provider agreement shall equal the sum of all of the 29969
following:29970

        (1) The rate for direct care costs determined for the nursing 29971
facility under section 5111.2315164.19 of the Revised Code;29972

        (2) The rate for ancillary and support costs determined for 29973
the nursing facility's ancillary and support cost peer group under 29974
section 5111.245164.20 of the Revised Code;29975

        (3) The rate for tax costs determined for the nursing 29976
facility under section 5111.2425164.21 of the Revised Code;29977

        (4) The rate for franchise permit fees determined for the 29978
nursing facility under section 5111.2435164.22 of the Revised 29979
Code;29980

        (5) The quality incentive payment paid to the nursing 29981
facility under section 5111.2445164.23 of the Revised Code;29982

        (6) The median rate for capital costs for the nursing 29983
facilities in the nursing facility's capital costs peer group as 29984
determined under section 5111.255164.24 of the Revised Code.29985

        (B) The department shall adjust the rates otherwise 29986
determined under divisions (A)(1), (2), (3), and (6) of this 29987
section as directed by the general assembly through the enactment 29988
of law governing medicaid payments to providers of nursing 29989
facilities, including any law that does either of the following:29990

        (1) Establishes factors by which the rates are to be 29991
adjusted;29992

        (2) Establishes a methodology for phasing in the rates 29993
determined for fiscal year 2006 under uncodified law the general 29994
assembly enacts to rates determined for subsequent fiscal years 29995
under sections 5111.205164.01 to 5111.335164.41 of the Revised 29996
Code.29997

       Sec. 5111.231.        Sec. 5164.19. (A) As used in this section, 29998
"applicable calendar year" means the following:29999

        (1) For the purpose of the department of job and family 30000
services'health care administration's initial determination under 30001
division (D) of this section of each peer group's cost per 30002
case-mix unit, calendar year 2003;30003

        (2) For the purpose of the department's subsequent 30004
determinations under division (D) of this section of each peer 30005
group's cost per case-mix unit, the calendar year the department 30006
selects.30007

        (B) The department of job and family serviceshealth care 30008
administration shall pay a provider for each of the provider's 30009
eligible nursing facilities a per resident per day rate for direct 30010
care costs determined semiannually by multiplying the cost per 30011
case-mix unit determined under division (D) of this section for 30012
the facility's peer group by the facility's semiannual case-mix 30013
score determined under section 5111.2325164.191 of the Revised 30014
Code.30015

        (C) For the purpose of determining nursing facilities' rate 30016
for direct care costs, the department shall establish three peer 30017
groups.30018

        Each nursing facility located in any of the following 30019
counties shall be placed in peer group one: Brown, Butler, 30020
Clermont, Clinton, Hamilton, and Warren.30021

        Each nursing facility located in any of the following 30022
counties shall be placed in peer group two: Ashtabula, Champaign, 30023
Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, Franklin, 30024
Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, Lorain, 30025
Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, Ottawa, 30026
Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, Union, 30027
and Wood.30028

        Each nursing facility located in any of the following 30029
counties shall be placed in peer group three: Adams, Allen, 30030
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 30031
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 30032
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 30033
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 30034
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 30035
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 30036
Washington, Wayne, Williams, and Wyandot.30037

        (D)(1) At least once every ten years, the department shall 30038
determine a cost per case-mix unit for each peer group established 30039
under division (C) of this section. A cost per case-mix unit 30040
determined under this division for a peer group shall be used for 30041
subsequent years until the department redetermines it. To 30042
determine a peer group's cost per case-mix unit, the department 30043
shall do all of the following:30044

        (a) Determine the cost per case-mix unit for each nursing 30045
facility in the peer group for the applicable calendar year by 30046
dividing each facility's desk-reviewed, actual, allowable, per 30047
diem direct care costs for the applicable calendar year by the 30048
facility's annual average case-mix score determined under section 30049
5111.2325164.191 of the Revised Code for the applicable calendar 30050
year.30051

        (b) Subject to division (D)(2) of this section, identify 30052
which nursing facility in the peer group is at the twenty-fifth 30053
percentile of the cost per case-mix units determined under 30054
division (D)(1)(a) of this section.30055

        (c) Calculate the amount that is seven per cent above the 30056
cost per case-mix unit determined under division (D)(1)(a) of this 30057
section for the nursing facility identified under division 30058
(D)(1)(b) of this section.30059

        (d) Multiply the amount calculated under division (D)(1)(c) 30060
of this section by the rate of inflation for the eighteen-month 30061
period beginning on the first day of July of the applicable 30062
calendar year and ending the last day of December of the calendar 30063
year immediately following the applicable calendar year using the 30064
employment cost index for total compensation, health services 30065
component, published by the United States bureau of labor 30066
statistics.30067

        (2) In making the identification under division (D)(1)(b) of 30068
this section, the department shall exclude both of the following:30069

        (a) Nursing facilities that participated in the medicaid 30070
program under the same provider for less than twelve months in the 30071
applicable calendar year;30072

        (b) Nursing facilities whose cost per case-mix unit is more 30073
than one standard deviation from the mean cost per case-mix unit 30074
for all nursing facilities in the nursing facility's peer group 30075
for the applicable calendar year.30076

        (3) The department shall not redetermine a peer group's cost 30077
per case-mix unit under this division based on additional 30078
information that it receives after the peer group's per case-mix 30079
unit is determined. The department shall redetermine a peer 30080
group's cost per case-mix unit only if it made an error in 30081
determining the peer group's cost per case-mix unit based on 30082
information available to the department at the time of the 30083
original determination.30084

       Sec. 5111.232.        Sec. 5164.191.  (A)(1) The department of job and 30085
family serviceshealth care administration shall determine 30086
semiannual and annual average case-mix scores for nursing 30087
facilities by using all of the following:30088

       (a) Data from a resident assessment instrument specified in 30089
rules adopted under section 5111.025163.15 of the Revised Code 30090
pursuant to section 1919(e)(5) of the "Social Security Act," 4930091
Stat. 620 (1935), 42 U.S.C.A. 1396r(e)(5), as amended, for the 30092
following residents:30093

        (i) When determining semi-annualsemiannual case-mix scores, 30094
each resident who is a medicaid recipient;30095

        (ii) When determining annual average case-mix scores, each 30096
resident regardless of payment source.30097

        (b) Except as provided in rules authorized by division30098
divisions (A)(2)(a) and (b) of this section, the case-mix values30099
established by the United States department of health and human30100
services;30101

       (c) Except as modified in rules authorized by division30102
(A)(2)(c) of this section, the grouper methodology used on June 30103
30, 1999, by the United States department of health and human 30104
services for prospective payment of skilled nursing facilities 30105
under the medicare program established by Title XVIII.30106

       (2) The director of job and family serviceshealth care 30107
administration may adopt rules under section 5111.025163.15 of30108
the Revised Code that do any of the following:30109

       (a) Adjust the case-mix values specified in division 30110
(A)(1)(b) of this section to reflect changes in relative wage 30111
differentials that are specific to this state;30112

       (b) Express all of those case-mix values in numeric terms30113
that are different from the terms specified by the United States30114
department of health and human services but that do not alter the30115
relationship of the case-mix values to one another;30116

       (c) Modify the grouper methodology specified in division 30117
(A)(1)(c) of this section as follows:30118

       (i) Establish a different hierarchy for assigning residents30119
to case-mix categories under the methodology;30120

       (ii) Prohibit the use of the index maximizer element of the30121
methodology;30122

       (iii) Incorporate changes to the methodology the United30123
States department of health and human services makes after June30124
30, 1999;30125

       (iv) Make other changes the department determines are 30126
necessary.30127

       (B) The department shall determine case-mix scores for30128
intermediate care facilities for the mentally retarded using data30129
for each resident, regardless of payment source, from a resident30130
assessment instrument and grouper methodology prescribed in rules30131
adopted under section 5111.02 of the Revised Code and expressed in 30132
case-mix values established by the department in those rules.30133

       (C) Each calendar quarter, each provider of a nursing 30134
facility shall compile complete assessment data, from the resident 30135
assessment instrument specified in rules authorized by division 30136
(A) or (B) of this section, for each resident of each of the 30137
provider's nursing facilities, regardless of payment source, who 30138
was in the facility or on hospital or therapeutic leave from the 30139
facility on the last day of the quarter. Providers of a nursing 30140
facility shall submit the data to the department of health and, if 30141
required by rules, the department of job and family services30142
health care administration. Providers of an intermediate care 30143
facility for the mentally retarded shall submit the data to the 30144
department of job and family services. The data shall be submitted 30145
not later than fifteen days after the end of the calendar quarter 30146
for which the data is compiled.30147

       Except as provided in division (D)(C) of this section, the30148
department, every six months and after the end of each calendar 30149
year, shall calculate a semiannual and annual average case-mix 30150
score for each nursing facility using the facility's quarterly30151
case-mix scores for that six-month period or calendar year. Also 30152
except as provided in division (D) of this section, the 30153
department, after the end of each calendar year, shall calculate 30154
an annual average case-mix score for each intermediate care 30155
facility for the mentally retarded using the facility's quarterly 30156
case-mix scores for that calendar year. The department shall make 30157
the calculations pursuant to procedures specified in rules adopted 30158
under section 5111.025163.15 of the Revised Code.30159

       (D)(C)(1) If a provider of a nursing facility does not timely 30160
submit information for a calendar quarter necessary to calculate a 30161
facility's case-mix score, or submits incomplete or inaccurate 30162
information for a calendar quarter, the department may assign the 30163
facility a quarterly average case-mix score that is five per cent 30164
less than the facility's quarterly average case-mix score for the 30165
preceding calendar quarter. If the facility was subject to an 30166
exception review under division (C) of section 5111.275164.38 of 30167
the Revised Code for the preceding calendar quarter, the 30168
department may assign a quarterly average case-mix score that is 30169
five per cent less than the score determined by the exception 30170
review. If the facility was assigned a quarterly average case-mix 30171
score for the preceding quarter, the department may assign a 30172
quarterly average case-mix score that is five per cent less than 30173
that score assigned for the preceding quarter.30174

       The department may use a quarterly average case-mix score30175
assigned under division (D)(C)(1) of this section, instead of a30176
quarterly average case-mix score calculated based on the 30177
provider's submitted information, to calculate the facility's rate30178
for direct care costs being established under section 5111.23 or 30179
5111.2315164.19 of the Revised Code for one or more months, as 30180
specified in rules authorized by division (E)(D) of this section, 30181
of the quarter for which the rate established under section 30182
5111.23 or 5111.2315164.19 of the Revised Code will be paid.30183

       Before taking action under division (D)(C)(1) of this 30184
section, the department shall permit the provider a reasonable 30185
period of time, specified in rules authorized by division (E)(D)30186
of this section, to correct the information. In the case of an30187
intermediate care facility for the mentally retarded, the30188
department shall not assign a quarterly average case-mix score due30189
to late submission of corrections to assessment information unless30190
the provider fails to submit corrected information prior to the30191
eighty-first day after the end of the calendar quarter to which30192
the information pertains. In the case of a nursing facility, the30193
The department shall not assign a quarterly average case-mix score 30194
due to late submission of corrections to assessment information 30195
unless the provider fails to submit corrected information prior to 30196
the earlier of the eighty-first day after the end of the calendar30197
quarter to which the information pertains or the deadline for30198
submission of such corrections established by regulations adopted30199
by the United States department of health and human services under30200
Titles XVIII and XIX.30201

       (2) If a provider is paid a rate for a nursing facility 30202
calculated using a quarterly average case-mix score assigned under 30203
division (D)(C)(1) of this section for more than six months in a 30204
calendar year, the department may assign the facility a cost per 30205
case-mix unit that is five per cent less than the facility's 30206
actual or assigned cost per case-mix unit for the preceding 30207
calendar year. The department may use the assigned cost per 30208
case-mix unit, instead of calculating the facility's actual cost 30209
per case-mix unit in accordance with section 5111.23 or 5111.23130210
5164.19 of the Revised Code, to establish the facility's rate for 30211
direct care costs for the following fiscal year.30212

       (3) The department shall take action under division (D)(C)(1)30213
or (2) of this section only in accordance with rules authorized by30214
division (E)(D) of this section. The department shall not take an30215
action that affects rates for prior payment periods except in30216
accordance with sections 5111.275164.38 and 5111.285164.39 of 30217
the Revised Code.30218

       (E)(D) The director shall adopt rules under section 5111.0230219
5163.15 of the Revised Code that do all of the following:30220

       (1) Specify whether providers of a nursing facility must 30221
submit the assessment data to the department of job and family 30222
serviceshealth care administration;30223

       (2) Specify the medium or media through which the completed30224
assessment data shall be submitted;30225

       (3) Establish procedures under which the assessment data 30226
shall be reviewed for accuracy and providers shall be notified of 30227
any data that requires correction;30228

       (4) Establish procedures for providers to correct assessment 30229
data and specify a reasonable period of time by which providers 30230
shall submit the corrections. The procedures may limit the content 30231
of corrections by providers of nursing facilities in the manner30232
required by regulations adopted by the United States department of30233
health and human services under Titles XVIII and XIX.30234

       (5) Specify when and how the department will assign case-mix30235
scores or costs per case-mix unit under division (D)(C) of this30236
section if information necessary to calculate the facility's 30237
case-mix score is not provided or corrected in accordance with the 30238
procedures established by the rules. Notwithstanding any other 30239
provision of sections 5111.205164.01 to 5111.335164.41 of the 30240
Revised Code, the rules also may provide for the following:30241

       (a) Exclusion of case-mix scores assigned under division (D) 30242
of this section from calculation of an intermediate care facility 30243
for the mentally retarded's annual average case-mix score and the 30244
maximum cost per case-mix unit for the facility's peer group;30245

       (b) Exclusion ofexcluding case-mix scores assigned under 30246
division (D)(C) of this section from calculation of a nursing 30247
facility's semiannual or annual average case-mix score and the 30248
cost per case-mix unit for the facility's peer group.30249

       Sec. 5111.24.        Sec. 5164.20. (A) As used in this section, 30250
"applicable calendar year" means the following:30251

        (1) For the purpose of the department of job and family 30252
services'health care administration's initial determination under 30253
division (D) of this section of each peer group's rate for 30254
ancillary and support costs, calendar year 2003;30255

        (2) For the purpose of the department's subsequent 30256
determinations under division (D) of this section of each peer 30257
group's rate for ancillary and support costs, the calendar year 30258
the department selects.30259

        (B) The department of job and family serviceshealth care 30260
administration shall pay a provider for each of the provider's 30261
eligible nursing facilities a per resident per day rate for 30262
ancillary and support costs determined for the nursing facility's 30263
peer group under division (D) of this section.30264

        (C) For the purpose of determining nursing facilities' rate 30265
for ancillary and support costs, the department shall establish 30266
six peer groups.30267

        Each nursing facility located in any of the following 30268
counties shall be placed in peer group one or two: Brown, Butler, 30269
Clermont, Clinton, Hamilton, and Warren. Each nursing facility 30270
located in any of those counties that has fewer than one hundred 30271
beds shall be placed in peer group one. Each nursing facility 30272
located in any of those counties that has one hundred or more beds 30273
shall be placed in peer group two.30274

        Each nursing facility located in any of the following 30275
counties shall be placed in peer group three or four: Ashtabula, 30276
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, 30277
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, 30278
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, 30279
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, 30280
Union, and Wood. Each nursing facility located in any of those 30281
counties that has fewer than one hundred beds shall be placed in 30282
peer group three. Each nursing facility located in any of those 30283
counties that has one hundred or more beds shall be placed in peer 30284
group four.30285

        Each nursing facility located in any of the following 30286
counties shall be placed in peer group five or six: Adams, Allen, 30287
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 30288
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 30289
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 30290
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 30291
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 30292
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 30293
Washington, Wayne, Williams, and Wyandot. Each nursing facility 30294
located in any of those counties that has fewer than one hundred 30295
beds shall be placed in peer group five. Each nursing facility 30296
located in any of those counties that has one hundred or more beds 30297
shall be placed in peer group six.30298

        (D)(1) At least once every ten years, the department shall 30299
determine the rate for ancillary and support costs for each peer 30300
group established under division (C) of this section. The rate for 30301
ancillary and support costs determined under this division for a 30302
peer group shall be used for subsequent years until the department 30303
redetermines it. To determine a peer group's rate for ancillary 30304
and support costs, the department shall do all of the following:30305

        (a) Determine the rate for ancillary and support costs for 30306
each nursing facility in the peer group for the applicable 30307
calendar year by using the greater of the nursing facility's 30308
actual inpatient days for the applicable calendar year or the 30309
inpatient days the nursing facility would have had for the 30310
applicable calendar year if its occupancy rate had been ninety per 30311
cent. For the purpose of determining a nursing facility's 30312
occupancy rate under division (D)(1)(a) of this section, the 30313
department shall include any beds that the nursing facility 30314
removes from its medicaid-certified capacity unless the nursing 30315
facility also removes the beds from its licensed bed capacity.30316

        (b) Subject to division (D)(2) of this section, identify 30317
which nursing facility in the peer group is at the twenty-fifth 30318
percentile of the rate for ancillary and support costs for the 30319
applicable calendar year determined under division (D)(1)(a) of 30320
this section.30321

        (c) Calculate the amount that is three per cent above the 30322
rate for ancillary and support costs determined under division 30323
(D)(1)(a) of this section for the nursing facility identified 30324
under division (D)(1)(b) of this section.30325

        (d) Multiply the amount calculated under division (D)(1)(c) 30326
of this section by the rate of inflation for the eighteen-month 30327
period beginning on the first day of July of the applicable 30328
calendar year and ending the last day of December of the calendar 30329
year immediately following the applicable calendar year using the 30330
consumer price index for all items for all urban consumers for the 30331
north central region, published by the United States bureau of 30332
labor statistics.30333

        (2) In making the identification under division (D)(1)(b) of 30334
this section, the department shall exclude both of the following:30335

        (a) Nursing facilities that participated in the medicaid 30336
program under the same provider for less than twelve months in the 30337
applicable calendar year;30338

        (b) Nursing facilities whose ancillary and support costs are 30339
more than one standard deviation from the mean desk-reviewed, 30340
actual, allowable, per diem ancillary and support cost for all 30341
nursing facilities in the nursing facility's peer group for the 30342
applicable calendar year.30343

        (3) The department shall not redetermine a peer group's rate 30344
for ancillary and support costs under this division based on 30345
additional information that it receives after the rate is 30346
determined. The department shall redetermine a peer group's rate 30347
for ancillary and support costs only if it made an error in 30348
determining the rate based on information available to the 30349
department at the time of the original determination.30350

       Sec. 5111.242.        Sec. 5164.21. (A) As used in this section:30351

        (1) "Applicable calendar year" means the following:30352

        (a) For the purpose of the department of job and family 30353
services'health care administration's initial determination under 30354
this section of nursing facilities' rate for tax costs, calendar 30355
year 2003;30356

        (b) For the purpose of the department's subsequent 30357
determinations under division (D) of this section of nursing 30358
facilities' rate for tax costs, the calendar year the department 30359
selects.30360

        (2) "Tax costs" means the costs of taxes imposed under 30361
Chapter 5751. of the Revised Code, real estate taxes, personal 30362
property taxes, and corporate franchise taxes.30363

        (B) The department of job and family serviceshealth care 30364
administration shall pay a provider for each of the provider's 30365
eligible nursing facilities a per resident per day rate for tax 30366
costs determined under division (C) of this section.30367

        (C) At least once every ten years, the department shall 30368
determine the rate for tax costs for each nursing facility. The 30369
rate for tax costs determined under this division for a nursing 30370
facility shall be used for subsequent years until the department 30371
redetermines it. To determine a nursing facility's rate for tax 30372
costs, the department shall divide the nursing facility's 30373
desk-reviewed, actual, allowable tax costs paid for the applicable 30374
calendar year by the number of inpatient days the nursing facility 30375
would have had if its occupancy rate had been one hundred per cent 30376
during the applicable calendar year.30377

       Sec. 5111.243.        Sec. 5164.22. The department of job and family 30378
serviceshealth care administration shall pay a provider for each 30379
of the provider's eligible nursing facilities a per resident per 30380
day rate for the franchise permit fees paid for the nursing 30381
facility. The rate shall be equal to the franchise permit fee for 30382
the fiscal year for which the rate is paid.30383

       Sec. 5111.244.        Sec. 5164.23.  (A) As used in this section, 30384
"deficiency" and "standard survey" have the same meanings as in 30385
section 5111.355164.50 of the Revised Code.30386

       (B) Each fiscal year, the department of job and family 30387
serviceshealth care administration shall pay the provider of each 30388
nursing facility a quality incentive payment. The amount of a 30389
quality incentive payment paid to a provider for a fiscal year 30390
shall be based on the number of points the provider's nursing 30391
facility is awarded under division (C) of this section for that 30392
fiscal year. The amount of a quality incentive payment paid to a 30393
provider of a nursing facility that is awarded no points may be 30394
zero. The mean payment for fiscal year 2007, weighted by medicaid 30395
days, shall be three dollars per medicaid day. The department 30396
shall adjust the mean payment for subsequent fiscal years by the 30397
same adjustment factors the department uses to adjust, pursuant to 30398
division (B) of section 5111.2225164.18 of the Revised Code, 30399
nursing facilities' rates otherwise determined under divisions 30400
(A)(1), (2), (3), and (6) of that section.30401

        (C)(1) Except as provided by division (C)(2) of this section, 30402
the department shall annually award each nursing facility 30403
participating in the medicaid program one point for each of the 30404
following accountability measures the facility meets:30405

       (a) The facility had no health deficiencies on the facility's 30406
most recent standard survey.30407

       (b) The facility had no health deficiencies with a scope and 30408
severity level greater than E, as determined under nursing 30409
facility certification standards established under Title XIX, on 30410
the facility's most recent standard survey.30411

       (c) The facility's resident satisfaction is above the 30412
statewide average.30413

       (d) The facility's family satisfaction is above the statewide 30414
average.30415

       (e) The number of hours the facility employs nurses is above 30416
the statewide average.30417

       (f) The facility's employee retention rate is above the 30418
average for the facility's peer group established in division (C) 30419
of section 5111.2315164.19 of the Revised Code.30420

       (g) The facility's occupancy rate is above the statewide 30421
average.30422

       (h) The facility's medicaid utilization rate is above the 30423
statewide average.30424

       (i) The facility's case-mix score is above the statewide 30425
average.30426

       (2) The department shall award points pursuant to division 30427
(C)(1)(c) or (d) of this section only for a fiscal year 30428
immediately following a calendar year for which a survey of 30429
resident or family satisfaction has been conducted under section 30430
173.47 of the Revised Code.30431

       (D) The director of job and family serviceshealth care 30432
administration shall adopt rules under section 5111.025163.15 of 30433
the Revised Code as necessary to implement this section. The rules 30434
shall include rules establishing the system for awarding points 30435
under division (C) of this section.30436

       Sec. 5111.25.        Sec. 5164.24.  (A) As used in this section, 30437
"applicable calendar year" means the following:30438

        (1) For the purpose of the department of job and family 30439
services'health care administration's initial determination under 30440
division (D) of this section of each peer group's median rate for 30441
capital costs, calendar year 2003;30442

        (2) For the purpose of the department's subsequent 30443
determinations under division (D) of this section of each peer 30444
group's median rate for capital costs, the calendar year the 30445
department selects.30446

        (B) The department of job and family serviceshealth care 30447
administration shall pay a provider for each of the provider's 30448
eligible nursing facilities a per resident per day rate for 30449
capital costs. A nursing facility's rate for capital costs shall30450
be the median rate for capital costs for the nursing facilities in 30451
the nursing facility's peer group as determined under division (D) 30452
of this section. 30453

        (C) For the purpose of determining nursing facilities' rate 30454
for capital costs, the department shall establish six peer groups.30455

        Each nursing facility located in any of the following 30456
counties shall be placed in peer group one or two: Brown, Butler, 30457
Clermont, Clinton, Hamilton, and Warren. Each nursing facility 30458
located in any of those counties that has fewer than one hundred 30459
beds shall be placed in peer group one. Each nursing facility 30460
located in any of those counties that has one hundred or more beds 30461
shall be placed in peer group two.30462

        Each nursing facility located in any of the following 30463
counties shall be placed in peer group three or four: Ashtabula, 30464
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, 30465
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, 30466
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, 30467
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, 30468
Union, and Wood. Each nursing facility located in any of those 30469
counties that has fewer than one hundred beds shall be placed in 30470
peer group three. Each nursing facility located in any of those 30471
counties that has one hundred or more beds shall be placed in peer 30472
group four.30473

        Each nursing facility located in any of the following 30474
counties shall be placed in peer group five or six: Adams, Allen, 30475
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 30476
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 30477
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 30478
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 30479
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 30480
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 30481
Washington, Wayne, Williams, and Wyandot. Each nursing facility 30482
located in any of those counties that has fewer than one hundred 30483
beds shall be placed in peer group five. Each nursing facility 30484
located in any of those counties that has one hundred or more beds 30485
shall be placed in peer group six.30486

        (D)(1) At least once every ten years, the department shall 30487
determine the median rate for capital costs for each peer group 30488
established under division (C) of this section. The median rate 30489
for capital costs determined under this division for a peer group 30490
shall be used for subsequent years until the department 30491
redetermines it. To determine a peer group's median rate for 30492
capital costs, the department shall do both of the following:30493

        (a) Subject to division (D)(2) of this section, use the 30494
greater of each nursing facility's actual inpatient days for the 30495
applicable calendar year or the inpatient days the nursing 30496
facility would have had for the applicable calendar year if its 30497
occupancy rate had been one hundred per cent.30498

        (b) Exclude both of the following:30499

        (i) Nursing facilities that participated in the medicaid 30500
program under the same provider for less than twelve months in the 30501
applicable calendar year;30502

        (ii) Nursing facilities whose capital costs are more than one 30503
standard deviation from the mean desk-reviewed, actual, allowable, 30504
per diem capital cost for all nursing facilities in the nursing 30505
facility's peer group for the applicable calendar year.30506

        (2) For the purpose of determining a nursing facility's 30507
occupancy rate under division (D)(1)(a) of this section, the 30508
department shall include any beds that the nursing facility 30509
removes from its medicaid-certified capacity after June 30, 2005, 30510
unless the nursing facility also removes the beds from its 30511
licensed bed capacity.30512

       (E) Buildings shall be depreciated using the straight line30513
method over forty years or over a different period approved by the30514
department. Components and equipment shall be depreciated using30515
the straight-line method over a period designated in rules adopted 30516
under section 5111.025163.15 of the Revised Code, consistent with 30517
the guidelines of the American hospital association, or over a 30518
different period approved by the department. Any rules authorized 30519
by this division that specify useful lives of buildings, 30520
components, or equipment apply only to assets acquired on or after 30521
July 1, 1993. Depreciation for costs paid or reimbursed by any 30522
government agency shall not be included in capital costs unless30523
that part of the payment under sections 5111.205164.01 to 5111.3330524
5164.41 of the Revised Code is used to reimburse the government 30525
agency.30526

       (F) The capital cost basis of nursing facility assets shall30527
be determined in the following manner:30528

        (1) Except as provided in division (F)(3) of this section,30529
for purposes of calculating the rates to be paid for facilities 30530
with dates of licensure on or before June 30, 1993, the capital 30531
cost basis of each asset shall be equal to the desk-reviewed, 30532
actual, allowable, capital cost basis that is listed on the 30533
facility's cost report for the calendar year preceding the fiscal 30534
year during which the rate will be paid.30535

       (2) For facilities with dates of licensure after June 30,30536
1993, the capital cost basis shall be determined in accordance30537
with the principles of the medicare program established under30538
Title XVIII, except as otherwise provided in sections 5111.2030539
5164.01 to 5111.335164.41 of the Revised Code.30540

       (3) Except as provided in division (F)(4) of this section, if 30541
a provider transfers an interest in a facility to another provider30542
after June 30, 1993, there shall be no increase in the capital30543
cost basis of the asset if the providers are related parties or 30544
the provider to which the interest is transferred authorizes the 30545
provider that transferred the interest to continue to operate the 30546
facility under a lease, management agreement, or other 30547
arrangement. If the previous sentence does not prohibit the30548
adjustment of the capital cost basis under this division, the30549
basis of the asset shall be adjusted by the lesser of the30550
following:30551

       (a) One-half of the change in construction costs during the30552
time that the transferor held the asset, as calculated by the30553
department of job and family serviceshealth care administration30554
using the "Dodge building cost indexes, northeastern and north 30555
central states," published by Marshall and Swift;30556

       (b) One-half of the change in the consumer price index for30557
all items for all urban consumers, as published by the United30558
States bureau of labor statistics, during the time that the30559
transferor held the asset.30560

       (4) If a provider transfers an interest in a facility to30561
another provider who is a related party, the capital cost basis of30562
the asset shall be adjusted as specified in division (F)(3) of30563
this section if all of the following conditions are met:30564

       (a) The related party is a relative of owner;30565

       (b) Except as provided in division (F)(4)(c)(ii) of this30566
section, the provider making the transfer retains no ownership30567
interest in the facility;30568

       (c) The department of job and family serviceshealth care 30569
administration determines that the transfer is an arm's length30570
transaction pursuant to rules adopted under section 5111.0230571
5163.15 of the Revised Code. The rules shall provide that a 30572
transfer is an arm's length transaction if all of the following 30573
apply:30574

       (i) Once the transfer goes into effect, the provider that30575
made the transfer has no direct or indirect interest in the30576
provider that acquires the facility or the facility itself,30577
including interest as an owner, officer, director, employee,30578
independent contractor, or consultant, but excluding interest as a30579
creditor.30580

       (ii) The provider that made the transfer does not reacquire30581
an interest in the facility except through the exercise of a30582
creditor's rights in the event of a default. If the provider30583
reacquires an interest in the facility in this manner, the30584
department shall treat the facility as if the transfer never30585
occurred when the department calculates its reimbursement rates30586
for capital costs.30587

       (iii) The transfer satisfies any other criteria specified in30588
the rules.30589

       (d) Except in the case of hardship caused by a catastrophic30590
event, as determined by the department, or in the case of a30591
provider making the transfer who is at least sixty-five years of30592
age, not less than twenty years have elapsed since, for the same30593
facility, the capital cost basis was adjusted most recently under30594
division (F)(4) of this section or actual, allowable cost of30595
ownership was determined most recently under division (G)(9) of30596
this section.30597

       (G) As used in this division:30598

       "Imputed interest" means the lesser of the prime rate plus 30599
two per cent or ten per cent.30600

       "Lease expense" means lease payments in the case of an 30601
operating lease and depreciation expense and interest expense in 30602
the case of a capital lease. 30603

       "New lease" means a lease, to a different lessee, of a 30604
nursing facility that previously was operated under a lease.30605

       (1) Subject to division (B) of this section, for a lease of a 30606
facility that was effective on May 27, 1992, the entire lease 30607
expense is an actual, allowable capital cost during the term of 30608
the existing lease. The entire lease expense also is an actual, 30609
allowable capital cost if a lease in existence on May 27, 1992, is 30610
renewed under either of the following circumstances:30611

       (a) The renewal is pursuant to a renewal option that was in30612
existence on May 27, 1992;30613

       (b) The renewal is for the same lease payment amount and30614
between the same parties as the lease in existence on May 27,30615
1992.30616

       (2) Subject to division (B) of this section, for a lease of a 30617
facility that was in existence but not operated under a lease on 30618
May 27, 1992, actual, allowable capital costs shall include the 30619
lesser of the annual lease expense or the annual depreciation 30620
expense and imputed interest expense that would be calculated at 30621
the inception of the lease using the lessor's entire historical 30622
capital asset cost basis, adjusted by the lesser of the following 30623
amounts:30624

       (a) One-half of the change in construction costs during the30625
time the lessor held each asset until the beginning of the lease,30626
as calculated by the department using the "Dodge building cost30627
indexes, northeastern and north central states," published by30628
Marshall and Swift;30629

       (b) One-half of the change in the consumer price index for30630
all items for all urban consumers, as published by the United30631
States bureau of labor statistics, during the time the lessor held30632
each asset until the beginning of the lease.30633

       (3) Subject to division (B) of this section, for a lease of a 30634
facility with a date of licensure on or after May 27, 1992, that 30635
is initially operated under a lease, actual, allowable capital 30636
costs shall include the annual lease expense if there was a 30637
substantial commitment of money for construction of the facility 30638
after December 22, 1992, and before July 1, 1993. If there was not 30639
a substantial commitment of money after December 22, 1992, and 30640
before July 1, 1993, actual, allowable capital costs shall include 30641
the lesser of the annual lease expense or the sum of the 30642
following:30643

       (a) The annual depreciation expense that would be calculated30644
at the inception of the lease using the lessor's entire historical30645
capital asset cost basis;30646

       (b) The greater of the lessor's actual annual amortization of 30647
financing costs and interest expense at the inception of the lease 30648
or the imputed interest expense calculated at the inception of the 30649
lease using seventy per cent of the lessor's historical capital 30650
asset cost basis.30651

       (4) Subject to division (B) of this section, for a lease of a 30652
facility with a date of licensure on or after May 27, 1992, that 30653
was not initially operated under a lease and has been in existence 30654
for ten years, actual, allowable capital costs shall include the 30655
lesser of the annual lease expense or the annual depreciation 30656
expense and imputed interest expense that would be calculated at 30657
the inception of the lease using the entire historical capital 30658
asset cost basis of the lessor, adjusted by the lesser of the30659
following:30660

       (a) One-half of the change in construction costs during the30661
time the lessor held each asset until the beginning of the lease,30662
as calculated by the department using the "Dodge building cost30663
indexes, northeastern and north central states," published by30664
Marshall and Swift;30665

       (b) One-half of the change in the consumer price index for30666
all items for all urban consumers, as published by the United30667
States bureau of labor statistics, during the time the lessor held30668
each asset until the beginning of the lease.30669

       (5) Subject to division (B) of this section, for a new lease 30670
of a facility that was operated under a lease on May 27, 1992, 30671
actual, allowable capital costs shall include the lesser of the 30672
annual new lease expense or the annual old lease payment. If the 30673
old lease was in effect for ten years or longer, the old lease 30674
payment from the beginning of the old lease shall be adjusted by 30675
the lesser of the following:30676

       (a) One-half of the change in construction costs from the30677
beginning of the old lease to the beginning of the new lease, as30678
calculated by the department using the "Dodge building cost30679
indexes, northeastern and north central states," published by30680
Marshall and Swift;30681

       (b) One-half of the change in the consumer price index for30682
all items for all urban consumers, as published by the United30683
States bureau of labor statistics, from the beginning of the old30684
lease to the beginning of the new lease.30685

       (6) Subject to division (B) of this section, for a new lease 30686
of a facility that was not in existence or that was in existence 30687
but not operated under a lease on May 27, 1992, actual, allowable 30688
capital costs shall include the lesser of annual new lease expense 30689
or the annual amount calculated for the old lease under division 30690
(G)(2), (3), (4), or (6) of this section, as applicable. If the 30691
old lease was in effect for ten years or longer, the lessor's 30692
historical capital asset cost basis shall be adjusted by the 30693
lesser of the following for purposes of calculating the annual 30694
amount under division (G)(2), (3), (4), or (6) of this section:30695

       (a) One-half of the change in construction costs from the30696
beginning of the old lease to the beginning of the new lease, as30697
calculated by the department using the "Dodge building cost30698
indexes, northeastern and north central states," published by30699
Marshall and Swift;30700

       (b) One-half of the change in the consumer price index for30701
all items for all urban consumers, as published by the United30702
States bureau of labor statistics, from the beginning of the old30703
lease to the beginning of the new lease.30704

       In the case of a lease under division (G)(3) of this section30705
of a facility for which a substantial commitment of money was made30706
after December 22, 1992, and before July 1, 1993, the old lease30707
payment shall be adjusted for the purpose of determining the30708
annual amount.30709

       (7) For any revision of a lease described in division (G)(1), 30710
(2), (3), (4), (5), or (6) of this section, or for any subsequent 30711
lease of a facility operated under such a lease, other than 30712
execution of a new lease, the portion of actual, allowable capital 30713
costs attributable to the lease shall be the same as before the 30714
revision or subsequent lease.30715

       (8) Except as provided in division (G)(9) of this section, if 30716
a provider leases an interest in a facility to another provider30717
who is a related party or previously operated the facility, the 30718
related party's or previous operator's actual, allowable capital 30719
costs shall include the lesser of the annual lease expense or the 30720
reasonable cost to the lessor.30721

       (9) If a provider leases an interest in a facility to another 30722
provider who is a related party, regardless of the date of the 30723
lease, the related party's actual, allowable capital costs shall 30724
include the annual lease expense, subject to the limitations30725
specified in divisions (G)(1) to (7) of this section, if all of30726
the following conditions are met:30727

       (a) The related party is a relative of owner;30728

       (b) If the lessor retains an ownership interest, it is,30729
except as provided in division (G)(9)(c)(ii) of this section, in30730
only the real property and any improvements on the real property;30731

       (c) The department of job and family serviceshealth care 30732
administration determines that the lease is an arm's length 30733
transaction pursuant to rules adopted under section 5111.0230734
5163.15 of the Revised Code. The rules shall provide that a lease 30735
is an arm's length transaction if all of the following apply:30736

       (i) Once the lease goes into effect, the lessor has no direct 30737
or indirect interest in the lessee or, except as provided in 30738
division (G)(9)(b) of this section, the facility itself, including30739
interest as an owner, officer, director, employee, independent 30740
contractor, or consultant, but excluding interest as a lessor.30741

       (ii) The lessor does not reacquire an interest in the30742
facility except through the exercise of a lessor's rights in the30743
event of a default. If the lessor reacquires an interest in the30744
facility in this manner, the department shall treat the facility30745
as if the lease never occurred when the department calculates its30746
reimbursement rates for capital costs.30747

       (iii) The lease satisfies any other criteria specified in the30748
rules.30749

       (d) Except in the case of hardship caused by a catastrophic30750
event, as determined by the department, or in the case of a lessor30751
who is at least sixty-five years of age, not less than twenty30752
years have elapsed since, for the same facility, the capital cost30753
basis was adjusted most recently under division (F)(4) of this30754
section or actual, allowable capital costs were determined most30755
recently under division (G)(9) of this section.30756

       (10) This division does not apply to leases of specific items 30757
of equipment.30758

        (H) After the date on which a transaction of sale is closed, 30759
the provider shall refund to the department the amount of excess 30760
depreciation paid to the provider for the facility by the30761
department for each year the provider has operated the facility 30762
under a provider agreement and prorated according to the number of 30763
medicaid patient days for which the provider has received payment 30764
for the facility. The provider of a facility that is sold or that30765
voluntarily terminates participation in the medicaid program also 30766
shall refund any other amount that the department properly finds 30767
to be due after the audit conducted under this division. For the 30768
purposes of this division, "depreciation paid to the provider for 30769
the facility" means the amount paid to the provider for the 30770
nursing facility for capital costs pursuant to this section less 30771
any amount paid for interest costs, amortization of financing30772
costs, and lease expenses. For the purposes of this division, 30773
"excess depreciation" is the nursing facility's depreciated basis, 30774
which is the provider's cost less accumulated depreciation,30775
subtracted from the purchase price net of selling costs but not 30776
exceeding the amount of depreciation paid to the provider for the30777
facility.30778

       Sec. 5111.263.        Sec. 5164.26.  (A) As used in this section, "covered30779
therapy services" means physical therapy, occupational therapy,30780
audiology, and speech therapy services that are provided by30781
appropriately licensed therapists or therapy assistants and that30782
are covered for nursing facility residents either by the medicare30783
program established under Title XVIII or the medicaid program as 30784
specified in rules adopted by the director of job and family30785
serviceshealth care administration under section 5111.025163.1530786
of the Revised Code.30787

       (B) Except as provided in division (G) of this section, the 30788
costs of therapy are not allowable costs for nursing facilities 30789
for the purpose of determining rates under sections 5111.2030790
5164.01 to 5111.335164.41 of the Revised Code.30791

       (C) The department of job and family serviceshealth care 30792
administration shall process no claims for payment under the 30793
medicaid program for covered therapy services rendered to a 30794
resident of a nursing facility other than such claims submitted, 30795
in accordance with this section, by a nursing facility that has a 30796
valid provider agreement with the department.30797

       (D) Providers of nursing facilities may bill the department 30798
of job and family serviceshealth care administration for covered30799
therapy services the nursing facilities provide to residents of 30800
any nursing facility who are medicaid recipients and not eligible 30801
for the medicare program.30802

       (E) The department shall not process any claim for a covered 30803
therapy service provided to a nursing facility resident who is 30804
eligible for the medicare program unless the claim is for a 30805
copayment or deductible or the conditions in division (E)(1) or30806
(2) of this section apply:30807

       (1) The covered therapy service provided is, under the30808
federal statutes, regulations, or policies governing the medicare30809
program, not covered by the medicare program and the service is,30810
under the provisions of this chapter or the rules adopted under30811
this chapter, covered by the medicaid program.30812

       (2) All of the following apply:30813

       (a) The individual or entity who provided the covered therapy 30814
service was eligible to bill the medicare program for the service.30815

       (b) A complete, accurate, and timely claim was submitted to 30816
the medicare program and the program denied payment for the30817
service as not medically necessary for the resident. For the30818
purposes of division (E)(2)(b) of this section, a claim is not30819
considered to have been denied by the medicare program until30820
either a denial has been issued following a medicare fair hearing30821
or six months have elapsed since the request for a fair hearing30822
was filed.30823

       (c) The facility is required to provide or arrange for the30824
provision of the service by a licensed therapist or therapy30825
assistant to be in compliance with federal or state nursing30826
facility certification requirements for the medicaid program.30827

       (d) The claim for payment for the services under the medicaid 30828
program is accompanied by documentation that divisions (E)(2)(b) 30829
and (c) of this section apply to the service.30830

       (F) The reimbursement allowed by the department for covered 30831
therapy services provided to nursing facility residents and billed 30832
under division (D) or (E) of this section shall be fifteen per 30833
cent less than the fees it pays for the same services rendered to 30834
hospital outpatients. The director may adopt rules under section 30835
5111.025163.15 of the Revised Code establishing comparable fees 30836
for covered therapy services that are not included in its schedule 30837
of fees paid for services rendered to hospital outpatients.30838

       (G) A nursing facility's reasonable costs for rehabilitative, 30839
restorative, or maintenance therapy services rendered to facility 30840
residents by nurses or nurse aides, and the facility's overhead 30841
costs to support provision of therapy services provided to nursing 30842
facility residents, are allowable costs for the purposes of 30843
establishing rates under sections 5111.205164.01 to 5111.3330844
5164.41 of the Revised Code.30845

       Sec. 5111.257.        Sec. 5164.27.  If a provider of a nursing facility 30846
adds or replaces one or more medicaid certified beds to or at the 30847
nursing facility, or renovates one or more of the nursing 30848
facility's beds, the rate for the added, replaced, or renovated 30849
beds shall be the same as the rate for the nursing facility's 30850
existing beds.30851

       Sec. 5111.265.        Sec. 5164.28.  If one or more medicaid-certified 30852
beds are relocated from one nursing facility to another nursing 30853
facility owned by a different person or government entity and the 30854
application for the certificate of need authorizing the relocation 30855
is filed with the director of health on or after the effective 30856
date of this sectionJuly 1, 2005, amortization of the cost of 30857
acquiring operating rights for the relocated beds is not an 30858
allowable cost for the purpose of determining the nursing 30859
facility's medicaid reimbursement rate.30860

       Sec. 5111.34.        Sec. 5164.30.  The director of job and family 30861
serviceshealth care administration shall prepare an annual report 30862
containing recommendations on the methodology that should be used 30863
to transition paying providers of nursing facilities the rate 30864
determined for nursing facilities for one fiscal year to the 30865
immediately succeeding fiscal year. The director shall submit a 30866
copy of the annual report to the governor, the president and 30867
minority leader of the senate, and the speaker and minority leader 30868
of the house of representatives not later than the first day of 30869
each October.30870

       Sec. 5111.254.        Sec. 5164.32.  (A) The department of job and family 30871
serviceshealth care administration shall establish initial rates 30872
for a nursing facility with a first date of licensure that is on 30873
or after July 1, 2006, including a facility that replaces one or 30874
more existing facilities, or for a nursing facility with a first 30875
date of licensure before that date that was initially certified 30876
for the medicaid program on or after that date, in the following 30877
manner:30878

       (1) The rate for direct care costs shall be the product of 30879
the cost per case-mix unit determined under division (D) of 30880
section 5111.2315164.19 of the Revised Code for the facility's 30881
peer group and the nursing facility's case-mix score. For the 30882
purpose of division (A)(1) of this section, the nursing facility's 30883
case-mix score shall be the following:30884

        (a) Unless the nursing facility replaces an existing nursing 30885
facility that participated in the medicaid program immediately 30886
before the replacement nursing facility begins participating in 30887
the medicaid program, the median annual average case-mix score for 30888
the nursing facility's peer group;30889

        (b) If the nursing facility replaces an existing nursing 30890
facility that participated in the medicaid program immediately 30891
before the replacement nursing facility begins participating in 30892
the medicaid program, the semiannual case-mix score most recently 30893
determined under section 5111.2325164.191 of the Revised Code for 30894
the replaced nursing facility as adjusted, if necessary, to 30895
reflect any difference in the number of beds in the replaced and 30896
replacement nursing facilities.30897

       (2) The rate for ancillary and support costs shall be the30898
rate for the facility's peer group determined under division (D) 30899
of section 5111.245164.20 of the Revised Code.30900

       (3) The rate for capital costs shall be the median rate for 30901
the facility's peer group determined under division (D) of section 30902
5111.255164.24 of the Revised Code.30903

       (4) The rate for tax costs as defined in section 5111.24230904
5164.21 of the Revised Code shall be the median rate for tax costs 30905
for the facility's peer group in which the facility is placed 30906
under division (C) of section 5111.245164.20 of the Revised Code.30907

       (5) The quality incentive payment shall be the mean payment 30908
specified in division (B) of section 5111.2445164.23 of the 30909
Revised Code.30910

       (B) Subject to division (C) of this section, the department 30911
shall adjust the rates established under division (A) of this 30912
section effective the first day of July, to reflect new rate30913
calculations for all nursing facilities under sections 5111.2030914
5164.01 to 5111.335164.41 of the Revised Code.30915

       (C) If a rate for direct care costs is determined under this 30916
section for a nursing facility using the median annual average 30917
case-mix score for the nursing facility's peer group, the rate 30918
shall be redetermined to reflect the replacement nursing 30919
facility's actual semiannual case-mix score determined under 30920
section 5111.2325164.191 of the Revised Code after the nursing 30921
facility submits its first two quarterly assessment data that 30922
qualify for use in calculating a case-mix score in accordance with 30923
rules authorized by division (E)(D) of section 5111.2325164.19130924
of the Revised Code. If the nursing facility's quarterly 30925
submissions do not qualify for use in calculating a case-mix 30926
score, the department shall continue to use the median annual 30927
average case-mix score for the nursing facility's peer group in 30928
lieu of the nursing facility's semiannual case-mix score until 30929
the nursing facility submits two consecutive quarterly assessment 30930
data that qualify for use in calculating a case-mix score.30931

       Sec. 5111.258.        Sec. 5164.34.  (A) Notwithstanding sections 5111.2030932
5164.01 to 5111.335164.41 of the Revised Code, the director of30933
job and family serviceshealth care administration shall adopt 30934
rules under section 5111.025163.15 of the Revised Code that 30935
establish a methodology for calculating the prospective rates that 30936
will be paid each fiscal year to a provider for each of the 30937
provider's eligible nursing facilities and intermediate care 30938
facilities for the mentally retarded, and discrete units of the 30939
provider's nursing facilities or intermediate care facilities for 30940
the mentally retarded, that serve residents who have diagnoses or 30941
special care needs that require direct care resources that are not 30942
measured adequately by the applicable assessment instrument 30943
specified in rules authorized by section 5111.2325164.051 or 30944
5164.191 of the Revised Code, or who have diagnoses or special 30945
care needs specified in the rules as otherwise qualifying for 30946
consideration under this section. The facilities and units of 30947
facilities whose rates are established under this division may 30948
include, but shall not be limited to, any of the following:30949

       (1) In the case of nursing facilities, facilities and units 30950
of facilities that serve medically fragile pediatric residents, 30951
residents who are dependent on ventilators, or residents who have 30952
severe traumatic brain injury, end-stage Alzheimer's disease, or 30953
end-stage acquired immunodeficiency syndrome;30954

       (2) In the case of intermediate care facilities for the30955
mentally retarded, facilities and units of facilities that serve30956
residents who have complex medical conditions or severe behavioral 30957
problems.30958

       The department shall use the methodology established under30959
this division to pay for services rendered by such facilities and30960
units after June 30, 1993.30961

       The rules authorized by this division shall specify the30962
criteria and procedures the department will apply when designating 30963
facilities and units that qualify for calculation of rates under 30964
this division. The criteria shall include consideration of whether 30965
all of the allowable costs of the facility or unit would be paid 30966
by rates established under sections 5111.205164.01 to 5111.3330967
5164.41 of the Revised Code, and shall establish a minimum bed 30968
size for a facility or unit to qualify to have its rates 30969
established under this division. The criteria shall not be30970
designed to require that residents be served only in facilities30971
located in large cities. The methodology established by the rules 30972
shall consider the historical costs of providing care to the 30973
residents of the facilities or units.30974

       The rules may require that a facility designated under this30975
division or containing a unit designated under this division30976
receive authorization from the department to admit or retain a30977
resident to the facility or unit and shall specify the criteria30978
and procedures the department will apply when granting that30979
authorization.30980

       Notwithstanding any other provision of sections 5111.2030981
5164.01 to 5111.335164.41 of the Revised Code, the costs incurred 30982
by facilities or units whose rates are established under this 30983
division shall not be considered in establishing payment rates for 30984
other facilities or units.30985

       (B) The director may adopt rules under section 5111.0230986
5163.15 of the Revised Code under which the department,30987
notwithstanding any other provision of sections 5111.205164.01 to 30988
5111.335164.41 of the Revised Code, may adjust the rates 30989
determined under sections 5111.205164.01 to 5111.335164.41 of 30990
the Revised Code for a facility that serves a resident who has a 30991
diagnosis or special care need that, in the rules authorized by 30992
division (A) of this section, would qualify a facility or unit of 30993
a facility to have its rate determined under that division, but 30994
who is not in such a unit. The rules may require that a facility 30995
that qualifies for a rate adjustment under this division receive 30996
authorization from the department to admit or retain a resident 30997
who qualifies the facility for the rate adjustment and shall 30998
specify the criteria and procedures the department will apply when 30999
granting that authorization.31000

       Sec. 5111.33.        Sec. 5164.35.  Reimbursement to a provider under31001
sections 5111.205164.01 to 5111.325164.41 of the Revised Code 31002
shall include payments to the provider, at a rate equal to the 31003
percentage of the per resident per day rates that the department 31004
of job and family serviceshealth care administration has 31005
established for the provider's nursing facility or intermediate 31006
care facility for the mentally retarded under sections 5111.2031007
5164.01 to 5111.335164.41 of the Revised Code for the fiscal year 31008
for which the cost of services is reimbursed, to reserve a bed for 31009
a recipient during a temporary absence under conditions prescribed 31010
by the department, to include hospitalization for an acute 31011
condition, visits with relatives and friends, and participation in31012
therapeutic programs outside the facility, when the resident's31013
plan of care provides for such absence and federal participation31014
in the payments is available. The maximum period during which31015
payments may be made to reserve a bed shall not exceed the maximum 31016
period specified under federal regulations, and shall not be more 31017
than thirty days during any calendar year for hospital stays, 31018
visits with relatives and friends, and participation in31019
therapeutic programs. Recipients who have been identified by the31020
department as requiring the level of care of an intermediate care31021
facility for the mentally retarded shall not be subject to a31022
maximum period during which payments may be made to reserve a bed31023
if prior authorization of the department is obtained for hospital31024
stays, visits with relatives and friends, and participation in31025
therapeutic programs. The director of job and family services31026
health care administration shall adopt rules under section 5111.0231027
5163.15 of the Revised Code establishing conditions under which 31028
prior authorization may be obtained.31029

       Sec. 5111.26.        Sec. 5164.37.  (A)(1)(a) Except as provided in 31030
division (A)(1)(b) of this section, each provider shall file with 31031
the department of job and family serviceshealth care 31032
administration an annual cost report for each of the provider's 31033
nursing facilities and intermediate care facilities for the 31034
mentally retarded that participate in the medicaid program. A 31035
provider shall prepare the reports in accordance with guidelines 31036
established by the department. A report shall cover a calendar 31037
year or the portion of a calendar year during which the facility 31038
participated in the medicaid program. A provider shall file the 31039
reports within ninety days after the end of the calendar year. The31040
department, for good cause, may grant a fourteen-day extension of31041
the time for filing cost reports upon written request from a 31042
provider. The director of job and family serviceshealth care 31043
administration shall prescribe, in rules adopted under section 31044
5111.025163.15 of the Revised Code, the cost reporting form and a 31045
uniform chart of accounts for the purpose of cost reporting, and 31046
shall distribute cost reporting forms or computer software for 31047
electronic submission of the cost report to each provider at least 31048
sixty days before the reporting date.31049

       (b) If rates for a provider's nursing facility or 31050
intermediate care facility for the mentally retarded were most 31051
recently established under section 5111.2545164.32 or 5111.25531052
5164.12 of the Revised Code, the provider shall submit a cost 31053
report for that facility no later than ninety days after the end 31054
of the facility's first three full calendar months of operation. 31055
If a nursing facility or intermediate care facility for the 31056
mentally retarded undergoes a change of provider that the 31057
department determines, in accordance with rules adopted under 31058
section 5111.025163.15 of the Revised Code, is an arm's length 31059
transaction, the new provider shall submit a cost report for that 31060
facility not later than ninety days after the end of the 31061
facility's first three full calendar months of operation under the 31062
new provider. The provider of a facility that opens or undergoes a 31063
change of provider that is an arm's length transaction after the 31064
first day of October in any calendar year is not required to file 31065
a cost report for that calendar year.31066

       (c) If a nursing facility undergoes a change of provider that 31067
the department determines, in accordance with rules adopted under 31068
section 5111.025163.15 of the Revised Code, is not an armsarm's31069
length transaction, the new provider shall file a cost report 31070
under division (A)(1)(a) of this section for the facility. The 31071
cost report shall cover the portion of the calendar year during 31072
which the new provider operated the nursing facility and the 31073
portion of the calendar year during which the previous provider 31074
operated the nursing facility.31075

       (2) If a provider required to submit a cost report for a 31076
nursing facility or intermediate care facility for the mentally 31077
retarded does not file the report within the required time period 31078
or within fourteen days thereafter if an extension is granted 31079
under division (A)(1)(a) of this section, or files an incomplete 31080
or inadequate report for the facility, the department shall 31081
provide immediate written notice to the provider that the provider 31082
agreement for the facility will be terminated in thirty days 31083
unless the provider submits a complete and adequate cost report 31084
for the facility within thirty days. During the thirty-day 31085
termination period or any additional time allowed for an appeal of 31086
the proposed termination of a provider agreement, the provider 31087
shall be paid the facility's then current per resident per day31088
rate, minus two dollars. On July 1, 1994, the department shall31089
adjust the two-dollar reduction to reflect the rate of inflation31090
during the preceding twelve months, as shown in the consumer price 31091
index for all items for all urban consumers for the north central 31092
region, published by the United States bureau of labor statistics. 31093
On July 1, 1995, and the first day of July of each year 31094
thereafter, the department shall adjust the amount of the31095
reduction in effect during the previous twelve months to reflect31096
the rate of inflation during the preceding twelve months, as shown 31097
in the same index.31098

       (B) No provider shall report fines paid under sections31099
5111.355164.50 to 5111.625164.78 or section 5111.995164.99 of 31100
the Revised Code in any cost report filed under this section.31101

       (C) The department shall develop an addendum to the cost31102
report form that a provider may use to set forth costs that the 31103
provider believes may be disputed by the department. Any costs31104
reported by the provider on the addendum may be considered by the31105
department in setting the facility's rate. If the department does 31106
not consider the costs listed on the addendum in setting the31107
facility's rate, the provider may seek reconsideration of that31108
determination under section 5111.295164.41 of the Revised Code. 31109
If the department subsequently includes the costs listed in the 31110
addendum in the facility's rate, the department shall pay the 31111
provider interest at a reasonable rate established in rules 31112
adopted under section 5111.025163.15 of the Revised Code for the 31113
time that the rate paid excluded the costs.31114

       Sec. 5111.266.        Sec. 5164.371.  A provider of a nursing facility 31115
filing the facility's cost report with the department of job and 31116
family serviceshealth care administration under section 5111.2631117
5164.37 of the Revised Code shall report as a nonreimbursable 31118
expense the cost of the nursing facility's franchise permit fee.31119

       Sec. 5111.264.        Sec. 5164.372.  Except as provided in section 31120
5111.255164.24 or 5111.2515164.08 of the Revised Code, the costs 31121
of goods, services, and facilities, furnished to a provider by a 31122
related party are includable in the allowable costs of the31123
provider at the reasonable cost to the related party.31124

       Sec. 5111.27.        Sec. 5164.38.  (A) The department of job and family31125
serviceshealth care administration shall conduct a desk review of 31126
each cost report it receives under section 5111.265164.37 of the 31127
Revised Code. Based on the desk review, the department shall make 31128
a preliminary determination of whether the reported costs are 31129
allowable costs. The department shall notify each provider of 31130
whether any of the reported costs are preliminarily determined not 31131
to be allowable, the rate calculation under sections 5111.2031132
5164.01 to 5111.335164.41 of the Revised Code that results from 31133
that determination, and the reasons for the determination and 31134
resulting rate. The department shall allow the provider to verify 31135
the calculation and submit additional information.31136

       (B) The department may conduct an audit, as defined by rule 31137
adopted under section 5111.025163.15 of the Revised Code, of any 31138
cost report and shall notify the provider of its findings.31139

       Audits shall be conducted by auditors under contract with or 31140
employed by the department. The decision whether to conduct an 31141
audit and the scope of the audit, which may be a desk or field31142
audit, shall be determined based on prior performance of the31143
provider and may be based on a risk analysis or other evidence31144
that gives the department reason to believe that the provider has31145
reported costs improperly. A desk or field audit may be performed 31146
annually, but is required whenever a provider does not pass the 31147
risk analysis tolerance factors. The department shall issue the 31148
audit report no later than three years after the cost report is 31149
filed, or upon the completion of a desk or field audit on the 31150
report or a report for a subsequent cost reporting period,31151
whichever is earlier. During the time within which the department 31152
may issue an audit report, the provider may amend the cost report 31153
upon discovery of a material error or material additional 31154
information. The department shall review the amended cost report 31155
for accuracy and notify the provider of its determination.31156

       The department may establish a contract for the auditing of31157
facilities by outside firms. Each contract entered into by bidding 31158
shall be effective for one to two years. The department shall 31159
establish an audit manual and program which shall require that all 31160
field audits, conducted either pursuant to a contract or by 31161
department employees:31162

       (1) Comply with the applicable rules prescribed pursuant to 31163
Titles XVIII and XIX;31164

       (2) Consider generally accepted auditing standards prescribed 31165
by the American institute of certified public accountants;31166

       (3) Include a written summary as to whether the costs31167
included in the report examined during the audit are allowable and 31168
are presented fairly in accordance with generally accepted31169
accounting principles and department rules, and whether, in all31170
material respects, allowable costs are documented, reasonable, and 31171
related to patient care;31172

       (4) Are conducted by accounting firms or auditors who, during 31173
the period of the auditors' professional engagement or employment 31174
and during the period covered by the cost reports, do not have nor 31175
are committed to acquire any direct or indirect financial interest 31176
in the ownership, financing, or operation of a nursing facility or 31177
intermediate care facility for the mentally retarded in this 31178
state;31179

       (5) Are conducted by accounting firms or auditors who, as a 31180
condition of the contract or employment, shall not audit any31181
facility that has been a client of the firm or auditor;31182

       (6) Are conducted by auditors who are otherwise independent 31183
as determined by the standards of independence established by the 31184
American institute of certified public accountants;31185

       (7) Are completed within the time period specified by the31186
department;31187

       (8) Provide to the provider complete written interpretations 31188
that explain in detail the application of all relevant contract 31189
provisions, regulations, auditing standards, rate formulae, and 31190
departmental policies, with explanations and examples, that are 31191
sufficient to permit the provider to calculate with reasonable 31192
certainty those costs that are allowable and the rate to which the 31193
provider's facility is entitled.31194

       For the purposes of division (B)(4) of this section, 31195
employment of a member of an auditor's family by a nursing 31196
facility or intermediate care facility for the mentally retarded 31197
that the auditor does not review does not constitute a direct or 31198
indirect financial interest in the ownership, financing, or31199
operation of the facility.31200

       (C) The department, pursuant to rules adopted under section 31201
5111.025163.15 of the Revised Code, may conduct an exception 31202
review of assessment data submitted under section 5111.23231203
5164.051 or 5164.191 of the Revised Code. The department may 31204
conduct an exception review based on the findings of a 31205
certification survey conducted by the department of health, a risk 31206
analysis, or prior performance of the provider.31207

       Exception reviews shall be conducted at the facility by31208
appropriate health professionals under contract with or employed 31209
by the department of job and family serviceshealth care 31210
administration. The professionals may review resident assessment31211
forms and supporting documentation, conduct interviews, and31212
observe residents to identify any patterns or trends of inaccurate 31213
assessments and resulting inaccurate case-mix scores.31214

       The rules shall establish an exception review program that31215
requires that exception reviews do all of the following:31216

       (1) Comply with Titles XVIII and XIX;31217

       (2) Provide a written summary that states whether the31218
resident assessment forms have been completed accurately;31219

       (3) Are conducted by health professionals who, during the31220
period of their professional engagement or employment with the 31221
department, neither have nor are committed to acquire any direct 31222
or indirect financial interest in the ownership, financing, or 31223
operation of a nursing facility or intermediate care facility for 31224
the mentally retarded in this state;31225

       (4) Are conducted by health professionals who, as a condition 31226
of their engagement or employment with the department, shall not31227
review any provider that has been a client of the professional.31228

       For the purposes of division (C)(3) of this section, 31229
employment of a member of a health professional's family by a 31230
nursing facility or intermediate care facility for the mentally 31231
retarded that the professional does not review does not constitute 31232
a direct or indirect financial interest in the ownership,31233
financing, or operation of the facility.31234

       If an exception review is conducted before the effective date 31235
of the rate that is based on the case-mix data subject to the 31236
review and the review results in findings that exceed tolerance 31237
levels specified in the rules adopted under this division, the 31238
department, in accordance with those rules, may use the findings 31239
to recalculate individual resident case-mix scores, quarterly 31240
average facility case-mix scores, and annual average facility 31241
case-mix scores. The department may use the recalculated quarterly 31242
and annual facility average case-mix scores to calculate the 31243
facility's rate for direct care costs for the appropriate calendar 31244
quarter or quarters.31245

       (D) The department shall prepare a written summary of any31246
audit disallowance or exception review finding that is made after31247
the effective date of the rate that is based on the cost or31248
case-mix data. Where the provider is pursuing judicial or31249
administrative remedies in good faith regarding the disallowance31250
or finding, the department shall not withhold from the provider's 31251
current payments any amounts the department claims to be due from31252
the provider pursuant to section 5111.285164.39 of the Revised 31253
Code.31254

       (E) The department shall not reduce rates calculated under31255
sections 5111.205164.01 to 5111.335164.41 of the Revised Code on 31256
the basis that the provider charges a lower rate to any resident 31257
who is not eligible for the medicaid program.31258

       (F) The department shall adjust the rates calculated under31259
sections 5111.205164.01 to 5111.335164.41 of the Revised Code to 31260
account for reasonable additional costs that must be incurred by 31261
intermediate care facilities for the mentally retarded to comply 31262
with requirements of federal or state statutes, rules, or policies 31263
enacted or amended after January 1, 1992, or with orders issued by 31264
state or local fire authorities.31265

       Sec. 5111.28.        Sec. 5164.39.  (A) If a provider properly amends its 31266
cost report under section 5111.275164.38 of the Revised Code and 31267
the amended report shows that the provider received a lower rate 31268
under the original cost report than it was entitled to receive, 31269
the department of job and family serviceshealth care 31270
administration shall adjust the provider's rate prospectively to31271
reflect the corrected information. The department shall pay the31272
adjusted rate beginning two months after the first day of the31273
month after the provider files the amended cost report. If the31274
department finds, from an exception review of resident assessment31275
information conducted after the effective date of the rate for31276
direct care costs that is based on the assessment information,31277
that inaccurate assessment information resulted in the provider31278
receiving a lower rate than it was entitled to receive, the31279
department prospectively shall adjust the provider's rate31280
accordingly and shall make payments using the adjusted rate for31281
the remainder of the calendar quarter for which the assessment31282
information is used to determine the rate, beginning one month31283
after the first day of the month after the exception review is31284
completed.31285

       (B) If the provider properly amends its cost report under31286
section 5111.275164.38 of the Revised Code, the department makes 31287
a finding based on an audit under that section, or the department31288
makes a finding based on an exception review of resident31289
assessment information conducted under that section after the31290
effective date of the rate for direct care costs that is based on31291
the assessment information, any of which results in a31292
determination that the provider has received a higher rate than it31293
was entitled to receive, the department shall recalculate the31294
provider's rate using the revised information. The department31295
shall apply the recalculated rate to the periods when the provider31296
received the incorrect rate to determine the amount of the31297
overpayment. The provider shall refund the amount of the31298
overpayment.31299

       In addition to requiring a refund under this division, the31300
department may charge the provider interest at the applicable rate31301
specified in this division from the time the overpayment was made.31302

       (1) If the overpayment resulted from costs reported for31303
calendar year 1993, the interest shall be no greater than one and31304
one-half times the average bank prime rate.31305

       (2) If the overpayment resulted from costs reported for31306
subsequent calendar years:31307

       (a) The interest shall be no greater than two times the31308
average bank prime rate if the overpayment was equal to or less31309
than one per cent of the total medicaid payments to the provider31310
for the fiscal year for which the incorrect information was used31311
to establish a rate.31312

       (b) The interest shall be no greater than two and one-half31313
times the current average bank prime rate if the overpayment was31314
greater than one per cent of the total medicaid payments to the31315
provider for the fiscal year for which the incorrect information31316
was used to establish a rate.31317

       (C) The department also may impose the following penalties:31318

       (1) If a provider does not furnish invoices or other31319
documentation that the department requests during an audit within31320
sixty days after the request, no more than the greater of one31321
thousand dollars per audit or twenty-five per cent of the31322
cumulative amount by which the costs for which documentation was31323
not furnished increased the total medicaid payments to the31324
provider during the fiscal year for which the costs were used to31325
establish a rate;31326

       (2) If an exiting operator or owner fails to provide notice 31327
of a facility closure, voluntary termination, or voluntary 31328
withdrawal of participation in the medicaid program as required by31329
section 5111.665164.83 of the Revised Code, or an exiting 31330
operator or owner and entering operator fail to provide notice of 31331
a change of operator as required by section 5111.675164.84 of the 31332
Revised Code, no more than the current average bank prime rate 31333
plus four per cent of the last two monthly payments.31334

       (D) If the provider continues to participate in the medicaid 31335
program, the department shall deduct any amount that the provider 31336
is required to refund under this section, and the amount of any 31337
interest charged or penalty imposed under this section, from the 31338
next available payment from the department to the provider. The 31339
department and the provider may enter into an agreement under 31340
which the amount, together with interest, is deducted in 31341
installments from payments from the department to the provider.31342

       (E) The department shall transmit refunds and penalties to31343
the treasurer of state for deposit in the general revenue fund.31344

       (F) For the purpose of this section, the department shall31345
determine the average bank prime rate using statistical release31346
H.15, "selected interest rates," a weekly publication of the31347
federal reserve board, or any successor publication. If31348
statistical release H.15, or its successor, ceases to contain the31349
bank prime rate information or ceases to be published, the31350
department shall request a written statement of the average bank31351
prime rate from the federal reserve bank of Cleveland or the31352
federal reserve board.31353

       Sec. 5111.221.        Sec. 5164.40.  The department of job and family 31354
serviceshealth care administration shall make its best efforts 31355
each year to calculate rates under sections 5111.205164.01 to 31356
5111.335164.41 of the Revised Code in time to use them to make 31357
the payments due to providers by the fifteenth day of August. If 31358
the department is unable to calculate the rates so that they can 31359
be paid by that date, the department shall pay each provider the 31360
rate calculated for the provider's nursing facilities and 31361
intermediate care facilities for the mentally retarded under those 31362
sections at the end of the previous fiscal year. If the department 31363
also is unable to calculate the rates to make the payments due by 31364
the fifteenth day of September and the fifteenth day of October, 31365
the department shall pay the previous fiscal year's rate to make 31366
those payments. The department may increase by five per cent the 31367
previous fiscal year's rate paid for any facility pursuant to this 31368
section at the request of the provider. The department shall use 31369
rates calculated for the current fiscal year to make the payments 31370
due by the fifteenth day of November.31371

       If the rate paid to a provider for a facility pursuant to 31372
this section is lower than the rate calculated for the facility 31373
for the current fiscal year, the department shall pay the provider 31374
the difference between the two rates for the number of days for31375
which the provider was paid for the facility pursuant to this 31376
section. If the rate paid for a facility pursuant to this section 31377
is higher than the rate calculated for it for the current fiscal 31378
year, the provider shall refund to the department the difference 31379
between the two rates for the number of days for which the 31380
provider was paid for the facility pursuant to this section.31381

       Sec. 5111.29.        Sec. 5164.41.  (A) The director of job and family 31382
serviceshealth care administration shall adopt rules under 31383
section 5111.025163.15 of the Revised Code that establish a 31384
process under which a provider, or a group or association of 31385
providers, may seek reconsideration of rates established under 31386
sections 5111.205164.01 to 5111.335164.41 of the Revised Code,31387
including a rate for direct care costs recalculated before the31388
effective date of the rate as a result of an exception review of31389
resident assessment information conducted under section 5111.2731390
5164.38 of the Revised Code.31391

       (1) Except as provided in divisions (A)(2) to (4) of this31392
section, the only issue that a provider, group, or association may31393
raise in the rate reconsideration shall be whether the rate was31394
calculated in accordance with sections 5111.205164.01 to 5111.3331395
5164.41 of the Revised Code and the rules adopted under section 31396
5111.025163.15 of the Revised Code. The rules shall permit a 31397
provider, group, or association to submit written arguments or 31398
other materials that support its position. The rules shall specify 31399
time frames within which the provider, group, or association and 31400
the department must act. If the department determines, as a result 31401
of the rate reconsideration, that the rate established for one or 31402
more facilities of a provider is less than the rate to which the 31403
facility is entitled, the department shall increase the rate. If 31404
the department has paid the incorrect rate for a period of time, 31405
the department shall pay the provider the difference between the 31406
amount the provider was paid for that period for the facility and 31407
the amount the provider should have been paid for the facility.31408

       (2) The rules shall provide that during a fiscal year, the31409
department, by means of the rate reconsideration process, may31410
increase the rate determined for an intermediate care facility for 31411
the mentally retarded as calculated under sections 5111.2031412
5164.01 to 5111.335164.41 of the Revised Code if the provider of 31413
the facility demonstrates that the facility's actual, allowable 31414
costs have increased because of extreme circumstances. A facility 31415
may qualify for a rate increase only if the facility's per diem, 31416
actual, allowable costs have increased to a level that exceeds its 31417
total rate. The rules shall specify the circumstances that would 31418
justify a rate increase under division (A)(2) of this section. The 31419
rules shall provide that the extreme circumstances include natural 31420
disasters, renovations approved under division (D) of section31421
5111.2515164.08 of the Revised Code, an increase in workers'31422
compensation experience rating of greater than five per cent for a31423
facility that has an appropriate claims management program,31424
increased security costs for an inner-city facility, and a change31425
of ownership that results from bankruptcy, foreclosure, or31426
findings of violations of certification requirements by the31427
department of health. An increase under division (A)(2) of this31428
section is subject to any rate limitations or maximum rates31429
established by sections 5111.205164.01 to 5111.335164.41 of the 31430
Revised Code for specific cost centers. Any rate increase granted 31431
under division (A)(2) of this section shall take effect on the 31432
first day of the first month after the department receives the 31433
request.31434

       (3) The rules shall provide that the department, through the31435
rate reconsideration process, may increase an intermediate care 31436
facility for the mentally retarded's rate as calculated under 31437
sections 5111.205164.01 to 5111.335164.41 of the Revised Code if 31438
the department, in the department's sole discretion, determines 31439
that the rate as calculated under those sections works an extreme31440
hardship on the facility.31441

       (4) The rules shall provide that when beds certified for the 31442
medicaid program are added to an existing intermediate care 31443
facility for the mentally retarded or replaced at the same site, 31444
the department, through the rate reconsideration process, shall 31445
increase the intermediate care facility for the mentally 31446
retarded's rate for capital costs proportionately, as limited by 31447
any applicable limitation under section 5111.2515164.08 of the 31448
Revised Code, to account for the costs of the beds that are added 31449
or replaced. The department shall make this increase one month 31450
after the first day of the month after the department receives 31451
sufficient documentation of the costs. Any rate increase granted 31452
under division (A)(4) of this section after June 30, 1993, shall 31453
remain in effect until the effective date of a rate calculated 31454
under section 5111.2515164.08 of the Revised Code that includes 31455
costs incurred for a full calendar year for the bed addition or 31456
bed replacement. The facility shall report double accumulated31457
depreciation in an amount equal to the depreciation included in31458
the rate adjustment on its cost report for the first year of31459
operation. During the term of any loan used to finance a project31460
for which a rate adjustment is granted under division (A)(4) of31461
this section, if the facility is operated by the same provider,31462
the provider shall subtract from the interest costs it reports on31463
its cost report an amount equal to the difference between the31464
following:31465

       (a) The actual, allowable interest costs for the loan during31466
the calendar year for which the costs are being reported;31467

       (b) The actual, allowable interest costs attributable to the31468
loan that were used to calculate the rates paid to the provider 31469
for the facility during the same calendar year.31470

       (5) The department's decision at the conclusion of the31471
reconsideration process shall not be subject to any administrative31472
proceedings under Chapter 119. or any other provision of the31473
Revised Code.31474

       (B) All of the following are subject to an adjudication 31475
conducted in accordance with Chapter 119. of the Revised Code:31476

       (1) Any audit disallowance that the department makes as the31477
result of an audit under section 5111.275164.38 of the Revised 31478
Code;31479

       (2) Any adverse finding that results from an exception review 31480
of resident assessment information conducted under section 5111.2731481
5164.38 of the Revised Code after the effective date of the 31482
facility's rate that is based on the assessment information;31483

       (3) Any medicaid payment deemed an overpayment under section 31484
5111.6835164.853 of the Revised Code;31485

       (4) Any penalty the department imposes under division (C) of 31486
section 5111.285164.39 of the Revised Code or section 5111.68331487
5164.853 of the Revised Code.31488

       Sec. 5111.202.        Sec. 5164.45.  (A) As used in this section:31489

       (1) "Dementia" includes Alzheimer's disease or a related31490
disorder.31491

       (2) "Serious mental illness" means "serious mental illness," 31492
as defined by the United States department of health and human 31493
services in regulations adopted under section 1919(e)(7)(G)(i) of 31494
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 31495
as amended1396r(e)(7)(G)(i).31496

       (3) "Mentally ill individual" means an individual who has a 31497
serious mental illness other than either of the following:31498

       (a) A primary diagnosis of dementia;31499

       (b) A primary diagnosis that is not a primary diagnosis of31500
dementia and a primary diagnosis of something other than a serious 31501
mental illness.31502

       (4) "Mentally retarded individual" means an individual who is 31503
mentally retarded or has a related condition, as described in31504
section 1905(d) of the "Social Security Act42 U.S.C. 1396d(d)."31505

       (5) "Specialized services" means the services specified by31506
the United States department of health and human services in31507
regulations adopted under section 1919(e)(7)(G)(iii) of the31508
"Social Security Act42 U.S.C. 1396r(e)(7)(G)(iii)."31509

       (B)(1) Except as provided in division (D) of this section, no 31510
nursing facility shall admit as a resident any mentally ill31511
individual unless the facility has received evidence that the31512
department of mental health has determined both of the following31513
under section 5119.061 of the Revised Code:31514

       (a) That the individual requires the level of services31515
provided by a nursing facility because of the individual's31516
physical and mental condition;31517

       (b) Whether the individual requires specialized services for 31518
mental illness.31519

       (2) Except as provided in division (D) of this section, no31520
nursing facility shall admit as a resident any mentally retarded31521
individual unless the facility has received evidence that the31522
department of mental retardation and developmental disabilities31523
has determined both of the following under section 5123.021 of the 31524
Revised Code:31525

       (a) That the individual requires the level of services31526
provided by a nursing facility because of the individual's31527
physical and mental condition;31528

       (b) Whether the individual requires specialized services for 31529
mental retardation.31530

       (C) The department of job and family serviceshealth care 31531
administration shall not make payments under the medical 31532
assistancemedicaid program to a nursing facility on behalf of any 31533
individual who is admitted to the facility in violation of 31534
division (B) of this section for the period beginning on the date 31535
of admission and ending on the date the requirements of division 31536
(B) of this section are met.31537

       (D) A determination under division (B) of this section is not 31538
required for any individual who is exempted from the requirement 31539
that a determination be made by division (B)(2) of section 31540
5119.061 of the Revised Code or rules adopted by the department of 31541
mental health under division (E)(3) of that section, or by 31542
division (B)(2) of section 5123.021 of the Revised Code or rules 31543
adopted by the department of mental retardation and developmental 31544
disabilities under division (E)(3) of that section.31545

       Sec. 5111.203.        Sec. 5164.46.  Regardless of whether or not an 31546
applicant for admission to a nursing facility or resident of a 31547
nursing facility is an applicant for or recipient of medical 31548
assistancemedicaid, the department of job and family services31549
health care administration shall provide notice and an opportunity 31550
for a hearing to any applicant for admission to a nursing facility 31551
or resident of a nursing facility who is adversely affected by a 31552
determination made by the department of mental health under31553
section 5119.061 of the Revised Code or by the department of 31554
mental retardation and developmental disabilities under section 31555
5123.021 of the Revised Code. The hearing shall be conducted in 31556
the same manner as hearings conducted under section 5101.3531557
5160.34 of the Revised Code. Any decision made by the department 31558
of job and family serviceshealth care administration on the basis 31559
of the hearing is binding on the department of mental health and 31560
the department of mental retardation and developmental31561
disabilities.31562

       Sec. 5111.204.        Sec. 5164.47.  (A) As used in this section, 31563
"representative" means a person acting on behalf of an applicant 31564
for or recipient of medicaid. A representative may be a family 31565
member, attorney, hospital social worker, or any other person 31566
chosen to act on behalf of an applicant or recipient.31567

       (B) The department of job and family serviceshealth care 31568
administration may require each applicant for or recipient of 31569
medicaid who applies or intends to apply for admission to a 31570
nursing facility or resides in a nursing facility to undergo an 31571
assessment to determine whether the applicant or recipient needs 31572
the level of care provided by a nursing facility. The assessment 31573
may be performed concurrently with a long-term care consultation 31574
provided under section 173.42 of the Revised Code.31575

       To the maximum extent possible, the assessment shall be based 31576
on information from the resident assessment instrument specified 31577
in rules adopted by the director of job and family serviceshealth 31578
care administration under division (E)(D) of section 5111.23231579
5164.191 of the Revised Code. The assessment shall also be based 31580
on criteria and procedures established in rules adopted under 31581
division (F) of this section and information provided by the 31582
person being assessed or the person's representative. 31583

       The department of job and family serviceshealth care 31584
administration, or if the assessment is performed by an agency 31585
under contract with the department pursuant to division (G) of 31586
this section, the agency, shall, not later than the time the level 31587
of care determination based on the assessment is required to be 31588
provided under division (C) of this section, give written notice 31589
of its conclusions and the basis for them to the person assessed 31590
and, if the department of job and family serviceshealth care 31591
administration or agency under contract with the department has 31592
been informed that the person has a representative, to the31593
representative.31594

       (C) The department of job and family serviceshealth care 31595
administration or agency under contract with the department,31596
whichever performs the assessment, shall provide a level of care 31597
determination based on the assessment as follows:31598

       (1) In the case of a person applying or intending to apply31599
for admission to a nursing facility while hospitalized, not later 31600
than one of the following:31601

       (a) One working day after the person or the person's31602
representative submits the application or notifies the department 31603
of the person's intention to apply and submits all information 31604
required for providing the level of care determination, as 31605
specified in rules adopted under division (F)(2) of this section;31606

       (b) A later date requested by the person or the person's31607
representative.31608

       (2) In the case of a person applying or intending to apply 31609
for admission to a nursing facility who is not hospitalized, not 31610
later than one of the following:31611

       (a) Five calendar days after the person or the person's31612
representative submits the application or notifies the department31613
of the person's intention to apply and submits all information 31614
required for providing the level of care determination, as 31615
specified in rules adopted under division (F)(2) of this section;31616

       (b) A later date requested by the person or the person's31617
representative.31618

       (3) In the case of a person who resides in a nursing 31619
facility, not later than one of the following:31620

        (a) Five calendar days after the person or the person's 31621
representative submits an application for medical assistance31622
medicaid and submits all information required for providing the 31623
level of care determination, as specified in rules adopted under 31624
division (F)(2) of this section;31625

        (b) A later date requested by the person or the person's 31626
representative.31627

        (4) In the case of an emergency, as specified in rules 31628
adopted under division (F)(4) of this section, within the number 31629
of days specified in the rules.31630

       (D) A person assessed under this section or the person's 31631
representative may request a state hearing to dispute the 31632
conclusions reached by the department of job and family services31633
health care administration or agency under contract with the 31634
department on the basis of the assessment. The request for a 31635
state hearing shall be made in accordance with section 5101.3531636
5160.34 of the Revised Code. The department of job and family 31637
serviceshealth care administration or agency under contract with 31638
the department shall provide to the person or the person's 31639
representative and the nursing facility written notice of the 31640
person's right to request a state hearing. The notice shall 31641
include an explanation of the procedure for requesting a state 31642
hearing. If a state hearing is requested, the state shall be 31643
represented in the hearing by the department of job and family 31644
serviceshealth care administration or the agency under contract 31645
with the department, whichever performed the assessment.31646

       (E) A nursing facility that admits or retains a person31647
determined pursuant to an assessment required under this section 31648
not to need the level of care provided by the nursing facility 31649
shall not be reimbursed under the medicaid program for the 31650
person's care.31651

       (F) The director of job and family serviceshealth care 31652
administration shall adopt rules in accordance with Chapter 119. 31653
of the Revised Code to implement and administer this section. The 31654
rules shall include all of the following:31655

       (1) Criteria and procedures to be used in determining whether 31656
admission to a nursing facility or continued stay in a nursing 31657
facility is appropriate for the person being assessed;31658

       (2) Information the person being assessed or the person's31659
representative must provide to the department or agency under 31660
contract with the department for purposes of the assessment and 31661
providing a level of care determination based on the assessment;31662

       (3) Circumstances under which a person is not required to be 31663
assessed;31664

       (4) Circumstances that constitute an emergency for purposes 31665
of division (C)(4) of this section and the number of days within 31666
which a level of care determination must be provided in the case 31667
of an emergency.31668

       (G) Pursuant to section 5111.915161.05 of the Revised Code, 31669
the department of job and family serviceshealth care 31670
administration may enter into contracts in the form of interagency 31671
agreements with one or more other state agencies to perform the 31672
assessments required under this section. The interagency 31673
agreements shall specify the responsibilities of each agency in 31674
the performance of the assessments.31675

       Sec. 5111.35.        Sec. 5164.50.  As used in this section "a resident's31676
rights" means the rights of a nursing facility resident under31677
sections 3721.10 to 3721.17 of the Revised Code and subsection (c) 31678
of section 1819 or 1919 of the "Social Security Act," 49 Stat. 620 31679
(1935), 42 U.S.C.A. 301, as amended, and regulations issued under 31680
those subsections.31681

       As used in sections 5111.355164.50 to 5111.625164.78 of the 31682
Revised Code:31683

       (A) "Certification requirements" means the requirements for 31684
nursing facilities established under sections 1819 and 1919 of the 31685
"Social Security Act."31686

       (B) "Compliance" means substantially meeting all applicable 31687
certification requirements.31688

       (C) "Contracting agency" means a state agency that has31689
entered into a contract with the department of job and family 31690
serviceshealth care administration under section 5111.385164.5331691
of the Revised Code.31692

       (D)(1) "Deficiency" means a finding cited by the department 31693
of health during a survey, on the basis of one or more actions, 31694
practices, situations, or incidents occurring at a nursing 31695
facility, that constitutes a severity level three finding, 31696
severity level four finding, scope level three finding, or scope 31697
level four finding. Whenever the finding is a repeat finding, 31698
"deficiency" also includes any finding that is a severity level 31699
two and scope level one finding, a severity level two and scope 31700
level two finding, or a severity level one and scope level two 31701
finding.31702

       (2) "Cluster of deficiencies" means deficiencies that result 31703
from noncompliance with two or more certification requirements and 31704
are causing or resulting from the same action, practice, 31705
situation, or incident.31706

       (E) "Emergency" means either of the following:31707

       (1) A deficiency or cluster of deficiencies that creates a31708
condition of immediate jeopardy;31709

       (2) An unexpected situation or sudden occurrence of a serious 31710
or urgent nature that creates a substantial likelihood that one or 31711
more residents of a nursing facility may be seriously harmed if 31712
allowed to remain in the facility, including the following:31713

       (a) A flood or other natural disaster, civil disaster, or31714
similar event;31715

       (b) A labor strike that suddenly causes the number of staff 31716
members in a nursing facility to be below that necessary for 31717
resident care.31718

       (F) "Finding" means a finding of noncompliance with31719
certification requirements determined by the department of health31720
under section 5111.415164.56 of the Revised Code.31721

       (G) "Immediate jeopardy" means that one or more residents of 31722
a nursing facility are in imminent danger of serious physical or 31723
life-threatening harm.31724

       (H) "Medicaid eligible resident" means a person who is a31725
resident of a nursing facility, or is applying for admission to a31726
nursing facility, and is eligible to receive financial assistance31727
under the medical assistancemedicaid program for the care the 31728
person receives in such a facility.31729

       (I) "Noncompliance" means failure to substantially meet all 31730
applicable certification requirements.31731

       (J) "Nursing facility" has the same meaning as in section31732
5111.205164.01 of the Revised Code.31733

       (K) "Provider" means a person, institution, or entity that31734
furnishes nursing facility services under a medical assistance 31735
programmedicaid provider agreement.31736

       (L) "Repeat finding" or "repeat deficiency" means a finding 31737
or deficiency cited pursuant to a survey, to which both of the 31738
following apply:31739

       (1) The finding or deficiency involves noncompliance with the 31740
same certification requirement, and the same kind of actions,31741
practices, situations, or incidents caused by or resulting from31742
the noncompliance, as were cited in the immediately preceding31743
standard survey or another survey conducted subsequent to the31744
immediately preceding standard survey of the facility. For31745
purposes of this division, actions, practices, situations, or31746
incidents may be of the same kind even though they involve31747
different residents, staff, or parts of the facility.31748

       (2) The finding or deficiency is cited subsequent to a31749
determination by the department of health that the finding or31750
deficiency cited on the immediately preceding standard survey, or31751
another survey conducted subsequent to the immediately preceding31752
standard survey, had been corrected.31753

       (M)(1) "Scope level one finding" means a finding of31754
noncompliance by a nursing facility in which the actions,31755
situations, practices, or incidents causing or resulting from the31756
noncompliance affect one or a very limited number of facility31757
residents and involve one or a very limited number of facility31758
staff members.31759

       (2) "Scope level two finding" means a finding of31760
noncompliance by a nursing facility in which the actions,31761
situations, practices, or incidents causing or resulting from the31762
noncompliance affect more than a limited number of facility31763
residents or involve more than a limited number of facility staff31764
members, but the number or percentage of facility residents31765
affected or staff members involved and the number or frequency of31766
the actions, situations, practices, or incidents in short31767
succession does not establish any reasonable degree of31768
predictability of similar actions, situations, practices, or31769
incidents occurring in the future.31770

       (3) "Scope level three finding" means a finding of31771
noncompliance by a nursing facility in which the actions,31772
situations, practices, or incidents causing or resulting from the31773
noncompliance affect more than a limited number of facility31774
residents or involve more than a limited number of facility staff31775
members, and the number or percentage of facility residents31776
affected or staff members involved or the number or frequency of31777
the actions, situations, practices, or incidents in short31778
succession establishes a reasonable degree of predictability of31779
similar actions, situations, practices, or incidents occurring in31780
the future.31781

       (4) "Scope level four finding" means a finding of31782
noncompliance by a nursing facility causing or resulting from31783
actions, situations, practices, or incidents that involve a31784
sufficient number or percentage of facility residents or staff31785
members or occur with sufficient regularity over time that the31786
noncompliance can be considered systemic or pervasive in the31787
facility.31788

       (N)(1) "Severity level one finding" means a finding of31789
noncompliance by a nursing facility that has not caused and, if31790
continued, is unlikely to cause physical harm to a facility31791
resident, mental or emotional harm to a resident, or a violation31792
of a resident's rights that results in physical, mental, or31793
emotional harm to the resident.31794

       (2) "Severity level two finding" means a finding of31795
noncompliance by a nursing facility that, if continued over time,31796
will cause, or is likely to cause, physical harm to a facility31797
resident, mental or emotional harm to a resident, or a violation31798
of a resident's rights that results in physical, mental, or31799
emotional harm to the resident.31800

       (3) "Severity level three finding" means a finding of31801
noncompliance by a nursing facility that has caused physical harm31802
to a facility resident, mental or emotional harm to a resident, or 31803
a violation of a resident's rights that results in physical,31804
mental, or emotional harm to the resident.31805

       (4) "Severity level four finding" means a finding of31806
noncompliance by a nursing facility that has caused31807
life-threatening harm to a facility resident or caused a31808
resident's death.31809

       (O) "State agency" has the same meaning as in section 1.60 of 31810
the Revised Code.31811

       (P) "Substandard care" means care furnished in a facility in 31812
which the department of health has cited a deficiency or31813
deficiencies that constitute one of the following:31814

       (1) A severity level four finding, regardless of scope;31815

       (2) A severity level three and scope level four finding, in 31816
the quality of care provided to residents;31817

       (3) A severity level three and scope level three finding, in 31818
the quality of care provided to residents.31819

       (Q)(1) "Survey" means a survey of a nursing facility31820
conducted under section 5111.395164.54 of the Revised Code.31821

       (2) "Standard survey" means a survey conducted by the31822
department of health under division (A) of section 5111.395164.5431823
of the Revised Code and includes an extended survey.31824

       (3) "Follow-up survey" means a survey conducted by the31825
department of health to determine whether a nursing facility has31826
substantially corrected deficiencies cited in a previous survey.31827

       Sec. 5111.36.        Sec. 5164.51.  The director of job and family 31828
serviceshealth care administration may adopt rules under Chapter 31829
119. of the Revised Code that are consistent with regulations, 31830
guidelines, and procedures issued by the United States secretary 31831
of health and human services under sections 1819 and 1919 of the 31832
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as 31833
amended,1395i-3 and 1396r and necessary for administration and31834
enforcement of sections 5111.355164.50 to 5111.625164.78 of the 31835
Revised Code. If the secretary does not issue appropriate 31836
regulations for enforcement of sections 1819 and 1919 of the 31837
"Social Security Act"42 U.S.C. 1395i-3 and 1396r on or before31838
December 13, 1990, the director of job and family serviceshealth 31839
care administration may adopt, under Chapter 119. of the Revised 31840
Code, rules that are consistent with those sections and with 31841
sections 5111.355164.50 to 5111.625164.78 of the Revised Code.31842

       Sec. 5111.37.        Sec. 5164.52.  The department of job and family 31843
serviceshealth care administration is hereby authorized to 31844
enforce sections 5111.355164.50 to 5111.625164.78 of the Revised31845
Code. The department may enforce the sections directly or through 31846
contracting agencies. The department and agencies shall enforce 31847
the sections in accordance with the requirements of sections 1819 31848
and 1919 of the "Social Security Act," 49 Stat. 620 (1935), 42 31849
U.S.C.A. 301, as amended,1395i-3 and 1396r that apply to nursing31850
facilities; with regulations, guidelines, and procedures adopted31851
by the United States secretary of health and human services for31852
the enforcement of sections 1819 and 1919 of the "Social Security31853
Act"42 U.S.C. 1395i-3 and 1396r; and with the rules adopted under 31854
section 5111.365164.51 of the Revised Code. The department and 31855
agencies shall enforce sections 5111.355164.50 to 5111.625164.7831856
of the Revised Code for purposes of the medicare program, Title 31857
XVIII of the "Social Security Act," only to the extent prescribed 31858
by the regulations, guidelines, and procedures issued by the 31859
secretary under section 1819 of that act42 U.S.C. 1395i-3.31860

       Sec. 5111.38.        Sec. 5164.53.  The department of job and family 31861
serviceshealth care administration may enter into contracts with31862
other state agencies that authorize the agencies to perform all or 31863
part of the duties assigned to the department of job and family 31864
serviceshealth care administration under sections 5111.355164.5031865
to 5111.625164.78 of the Revised Code. Each contract shall 31866
specify the duties the agency is authorized to perform and the 31867
sections of the Revised Code under which the agency is authorized 31868
to perform those duties.31869

       Sec. 5111.39.        Sec. 5164.54.  (A) The department of health shall 31870
conduct a survey, titled a standard survey, of every nursing 31871
facility in this state on a statewide average of not more than 31872
once every twelve months. Each nursing facility shall undergo a 31873
standard survey at least once every fifteen months as a condition 31874
of meeting certification requirements. The department may extend a31875
standard survey; such a survey is titled an extended survey.31876

       (B) The department may conduct surveys in addition to31877
standard surveys when it considers them necessary.31878

       (C) The department shall conduct surveys in accordance with 31879
the regulations, guidelines, and procedures issued by the United 31880
States secretary of health and human services under Titles XVIII 31881
and XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 31882
U.S.C.A. 301, as amendedfor the medicare and medicaid programs, 31883
sections 5111.405164.55 to 5111.425164.58 of the Revised Code, 31884
and rules adopted under section 3721.022 of the Revised Code.31885

       Sec. 5111.40.        Sec. 5164.55.  (A) At the conclusion of each survey, 31886
the department of health survey team shall conduct an exit 31887
interview with the administrator or other person in charge of the 31888
nursing facility and any other facility staff members designated 31889
by the administrator or person in charge of the facility. During 31890
the exit interview, at the request of the administrator or other31891
person in charge of the facility, the survey team shall provide31892
one of the following, as selected by the survey team:31893

       (1) Copies of all survey notes and any other written31894
materials created during the survey;31895

       (2) A written summary of the survey team's recommendations31896
regarding findings of noncompliance with certification31897
requirements;31898

       (3) An audio or audiovisual recording of the interview. If 31899
the survey team selects this option, at least two copies of the 31900
recording shall be made and the survey team shall select one copy 31901
to be kept by the survey team for use by the department of health.31902

       (B) All expenses of copying under division (A)(1) of this31903
section or recording under division (A)(3) of this section,31904
including the cost of the copy of the recording kept by the survey 31905
team, shall be paid by the facility.31906

       Sec. 5111.41.        Sec. 5164.56.  (A) Except as provided in section 31907
3721.17 of the Revised Code, a finding shall be cited only on the 31908
basis of a survey and a determination that one or more actions,31909
practices, situations, or incidents at a nursing facility caused31910
or resulted from the facility's failure to comply with one or more 31911
certification requirements. The department of health shall31912
determine whether the actions, practices, situations, or incidents 31913
can be justified by either of the following:31914

       (1) The actions, practices, situations, or incidents resulted 31915
from a resident exercising the resident's rights guaranteed under 31916
the laws of the United States or of this state;31917

       (2) The actions, practices, situations, or incidents resulted 31918
from a facility following the orders of a person licensed under 31919
Chapter 4731. of the Revised Code to practice medicine or surgery 31920
or osteopathic medicine and surgery.31921

       (B) If the department of health determines both that the31922
actions, practices, situations, or incidents cannot be justified31923
by the factors identified in division (A) of this section and that 31924
one or more of the following are applicable, the department shall 31925
declare that the actions, practices, situations, or incidents 31926
constitute a finding:31927

       (1) The actions, practices, situations, or incidents could31928
have been prevented by one or more persons involved in the31929
facility's operation;31930

       (2) No person involved in the facility's operation identified 31931
the actions, practices, situations, or incidents prior to the 31932
survey;31933

       (3) Prior to the survey, no person involved in the facility's 31934
operation initiated action to correct the noncompliance caused by 31935
or resulting in the actions, practices, situations, or incidents;31936

       (4) The facility does not have in effect, if needed, a31937
contingency plan that is reasonably calculated to prevent31938
physical, mental, or emotional harm to residents while permanent31939
corrective action is being taken.31940

       (C) The department of health shall determine the severity31941
level and scope level of each finding.31942

       (D) A deficiency that is substantially corrected within the 31943
time limits specified in sections 5111.525164.68 to 5111.5631944
5164.72 of the Revised Code and for which no remedy is imposed, 31945
shall be counted as a deficiency for the purpose of determining 31946
whether a deficiency is a repeat deficiency.31947

       (E) Whenever the department of health determines that during 31948
the period between two surveys a finding existed at the facility, 31949
but the facility substantially corrected it prior to the second 31950
survey, the department shall cite it. However, the department of 31951
job and family serviceshealth care administration or a 31952
contracting agency shall impose a remedy only as provided in 31953
division (C) of section 5111.465164.62 of the Revised Code.31954

       (F) Immediately upon determining the severity and scope of a 31955
finding at a nursing facility, the department of health shall31956
notify the department of job and family serviceshealth care 31957
administration and any contracting agency of the finding, the 31958
severity and scope of the finding, and whether the finding creates 31959
immediate jeopardy. Immediately upon determining that an emergency 31960
exists at a facility that does not result from a deficiency that 31961
creates immediate jeopardy, the department of health shall notify 31962
the department of job and family serviceshealth care 31963
administration and any contracting agency.31964

       Sec. 5111.411.        Sec. 5164.57.  The results of a survey of a nursing 31965
facility that is conducted under section 5111.395164.54 of the 31966
Revised Code, including any statement of deficiencies and all 31967
findings and deficiencies cited in the statement on the basis of 31968
the survey, shall be used solely to determine the nursing 31969
facility's compliance with certification requirements or with this 31970
chapter or another chapter of the Revised Code. Those results of a31971
survey, that statement of deficiencies, and the findings and31972
deficiencies cited in that statement shall not be used in any31973
court or in any action or proceeding that is pending in any court31974
and are not admissible in evidence in any action or proceeding31975
unless that action or proceeding is an appeal of an administrative31976
action by the department of job and family serviceshealth care 31977
administration or contracting agency under this chapter or is an 31978
action by any department or agency of the state to enforce this 31979
chapter or another chapter of the Revised Code.31980

       Nothing in this section prohibits the results of a survey, a31981
statement of deficiencies, or the findings and deficiencies cited31982
in that statement on the basis of the survey under this section31983
from being used in a criminal investigation or prosecution.31984

       Sec. 5111.42.        Sec. 5164.58.  (A) Not later than ten days after an 31985
exit interview, the department of health shall deliver to the 31986
nursing facility a detailed statement, titled a statement of31987
deficiencies, setting forth all findings and deficiencies cited on 31988
the basis of the survey, including any finding cited pursuant to 31989
division (E) of section 5111.415164.56 of the Revised Code. The31990
statement shall indicate the severity and scope level of each31991
finding and fully describe the incidents or other facts that form31992
the basis of the department's determination of the existence of31993
each finding and deficiency. A failure by the survey team to31994
completely disclose in the exit interview every finding that may31995
result from the survey does not affect the validity of any finding 31996
or deficiency cited in the statement of deficiencies. On request 31997
of the facility, the department shall provide a copy of any 31998
written worksheet or other document produced by the survey team in 31999
making recommendations regarding scope and severity levels of 32000
findings and deficiencies.32001

       (B) At the same time the department of health delivers a32002
statement of deficiencies, it also shall deliver to the facility a 32003
separate written notice that states all of the following:32004

       (1) That the department of job and family serviceshealth 32005
care administration or a contracting agency will issue an order 32006
under section 5111.575164.73 of the Revised Code denying payment 32007
for any medicaid eligible residents admitted on and after the 32008
effective date of the order if the facility does not substantially 32009
correct, within ninety days after the exit interview, the 32010
deficiency or deficiencies cited in the statement of deficiencies 32011
in accordance with the plan of correction it submitted under 32012
section 5111.435164.59 of the Revised Code;32013

       (2) If a condition of substandard care has been cited on the 32014
basis of a standard survey and a condition of substandard care was 32015
also cited on the immediately preceding standard survey, that the 32016
department of job and family serviceshealth care administration32017
or a contracting agency will issue an order under section 5111.5732018
5164.73 of the Revised Code denying payment for any medicaid 32019
eligible residents admitted on and after the effective date of the 32020
order if a condition of substandard care is cited on the basis of 32021
the next standard survey;32022

       (3) That the department of job and family serviceshealth 32023
care administration or a contracting agency will issue an order 32024
under section 5111.585164.74 of the Revised Code terminating the 32025
facility's participation in the medical assistancemedicaid32026
program if either of the following applies:32027

       (a) The facility does not substantially correct the32028
deficiency or deficiencies in accordance with the plan of32029
correction it submitted under section 5111.435164.59 of the 32030
Revised Code within six months after the exit interview.32031

       (b) The facility substantially corrects the deficiency or32032
deficiencies within the six-month period, but after correcting it, 32033
the department of health, based on a follow-up survey conducted 32034
during the remainder of the six-month period, determines that the 32035
facility has failed to maintain compliance with certification 32036
requirements.32037

       Sec. 5111.43.        Sec. 5164.59.  Whenever a nursing facility receives a32038
statement of deficiencies under section 5111.425164.58 of the 32039
Revised Code, the facility shall submit to the department of 32040
health for its approval a plan of correction for each finding 32041
cited in the statement. The plan shall describe the actions the 32042
facility will take to correct each finding and specify the date by 32043
which each finding will be corrected. In the case of a finding 32044
cited pursuant to division (E) of section 5111.415164.56 of the 32045
Revised Code, the plan shall describe the actions the facility 32046
took to correct the finding and the date on which it was 32047
corrected.32048

       The department shall approve any plan that conforms to the32049
requirements for approval of plans of corrections established in32050
the regulations, guidelines, and procedures issued by the United32051
States secretary of health and human services under Titles XVIII32052
and XIX of the "Social Security Act," 49 Stat. 620 (1935), 4232053
U.S.C.A. 301, as amendedfor the medicare and medicaid programs. 32054
The department also shall approve any modification of an existing 32055
plan submitted by a facility, if the plan as modified conforms to 32056
those regulations, guidelines, and procedures. The department 32057
shall not reject a facility's plan of correction or modification 32058
on the ground that the facility disputes the finding, if the plan 32059
is reasonably calculated to correct the finding.32060

       A facility that complies with this section shall not be32061
considered to have admitted the existence of a finding cited by32062
the department.32063

       Sec. 5111.44.        Sec. 5164.60.  The department of health may appoint32064
employees of the department to conduct on-site monitoring of a32065
nursing facility whenever a finding is cited, including any32066
finding cited pursuant to division (E) of section 5111.415164.5632067
of the Revised Code, or an emergency is found to exist. 32068
Appointment of monitors under this section is not subject to 32069
appeal under section 5111.605164.76 or any other section of the 32070
Revised Code. No employee of a facility for which monitors are 32071
appointed, no person employed by the facility within the previous 32072
two years, and no person who currently has a consulting or other 32073
contract with the department or the facility, shall be appointed 32074
as a monitor under this section. Every monitor appointed under 32075
this section shall have the professional qualifications necessary 32076
to monitor correction of the finding or elimination of the32077
emergency.32078

       Sec. 5111.45.        Sec. 5164.61.  (A) If the department of health cites 32079
a deficiency or deficiencies that was not substantially corrected32080
before a survey and that does not constitute a severity level four 32081
finding or create immediate jeopardy, the department of job and32082
family serviceshealth care administration or a contracting agency 32083
shall permit the nursing facility to continue participating in the 32084
medical assistancemedicaid program for up to six months after the 32085
exit interview, if all of the following apply:32086

       (1) The facility meets the requirements, established in32087
regulations issued by the United States secretary of health and 32088
human services under Title XIX of the "Social Security Act," 4932089
Stat. 620 (1935), 42 U.S.C.A. 301, as amended,the medicaid 32090
program for certification of nursing facilities that have a 32091
deficiency.32092

       (2) The department of health has approved a plan of32093
correction submitted by the facility under section 5111.435164.5932094
of the Revised Code for each deficiency.32095

       (3) The provider agrees to repay the department of job and 32096
family serviceshealth care administration, in accordance with 32097
section 5111.585164.74 of the Revised Code, the federal share of 32098
all payments made by the department to the facility during the 32099
six-month period following the exit interview if the facility does 32100
not within the six-month period substantially correct the 32101
deficiency or deficiencies in accordance with the plan of 32102
correction submitted under section 5111.435164.59 of the Revised 32103
Code.32104

       (B) If any of the conditions in divisions (A)(1) to (3) of32105
this section do not apply, the department of job and family 32106
serviceshealth care administration or contracting agency shall 32107
issue an order terminating the facility's participation in the 32108
medical assistancemedicaid program. An order issued under this 32109
division is subject to appeal under Chapter 119. of the Revised 32110
Code. The order shall not take effect prior to the later of the 32111
thirtieth day after it is delivered to the facility or, if the 32112
order is appealed, the date on which a final adjudication order 32113
upholding the termination becomes effective pursuant to Chapter 32114
119. of the Revised Code.32115

       (C) At the time the department of job and family services32116
health care administration or contracting agency issues an order 32117
under division (B) of this section terminating a nursing 32118
facility's participation in the medical assistancemedicaid32119
program, it may also impose, subject to section 5111.505164.66 of 32120
the Revised Code, other remedies under sections 5111.465164.62 to 32121
5111.485164.64 of the Revised Code.32122

       Sec. 5111.46.        Sec. 5164.62.  (A) If the department of health cites 32123
a deficiency, or cluster of deficiencies, that was not32124
substantially corrected before a survey and constitutes a severity 32125
level four finding, the department of job and family services32126
health care administration or contracting agency shall, subject to 32127
sections 5111.525164.68 to 5111.565164.72 of the Revised Code, 32128
impose a remedy for the deficiency or cluster of deficiencies. The 32129
department or agency may act under either division (A)(1) or (2) 32130
of this section:32131

       (1) The department or agency may impose one or more of the32132
following remedies:32133

       (a) Issue an order terminating the nursing facility's32134
participation in the medical assistancemedicaid program.32135

       (b) Do either of the following:32136

       (i) Regardless of whether the provider consents, appoint a32137
temporary manager of the facility.32138

       (ii) Apply to the common pleas court of the county in which 32139
the facility is located for such injunctive or other equitable 32140
relief as is necessary for the appointment of a special master 32141
with such powers and authority over the facility and length of 32142
appointment as the court considers necessary.32143

       (c) Do either of the following:32144

       (i) Issue an order denying payment to the facility under the 32145
medical assistancemedicaid program for all medicaid eligible32146
residents admitted after the effective date of the order;32147

       (ii) Impose a fine.32148

       (d) Issue an order denying payment to the facility under the 32149
medical assistancemedicaid program for medicaid eligible 32150
residents admitted after the effective date of the order who have 32151
certain diagnoses or special care needs specified by the 32152
department or agency.32153

       (2) The department or agency may impose one or more of the32154
following remedies:32155

       (a) Appoint, subject to the continuing consent of the32156
provider, a temporary manager of the facility;32157

       (b) Do either of the following:32158

       (i) Regardless of whether the provider consents, appoint a32159
temporary manager of the facility;32160

       (ii) Apply to the common pleas court of the county in which 32161
the facility is located for such injunctive or other equitable 32162
relief as is necessary for the appointment of a special master 32163
with such powers and authority over the facility and length of 32164
appointment as the court considers necessary.32165

       (c) Do either of the following:32166

       (i) Issue an order denying payment to the facility under the 32167
medical assistancemedicaid program for all medicaid eligible32168
residents admitted after the effective date of the order;32169

       (ii) Impose a fine.32170

       (d) Issue an order denying payment to the facility under the 32171
medical assistancemedicaid program for medicaid eligible 32172
residents admitted after the effective date of the order who have 32173
certain diagnoses or special care needs specified by the 32174
department or agency;32175

       (e) Issue an order requiring the facility to correct the32176
deficiency or cluster of deficiencies under the plan of correction 32177
submitted by the facility and approved by the department of health 32178
under section 5111.435164.59 of the Revised Code.32179

       (B) The department of job and family serviceshealth care 32180
administration or contracting agency shall deliver a written order 32181
issued under division (A)(1) of this section terminating a nursing 32182
facility's participation in the medical assistancemedicaid32183
program to the facility within five days after the exit interview. 32184
If the facility alleges, at any time prior to the later of the 32185
twentieth day after the exit interview or the fifteenth day after 32186
it receives the order, that the deficiency or cluster of 32187
deficiencies for which the order was issued has been substantially 32188
corrected, the department of health shall conduct a follow-up 32189
survey to determine whether the deficiency or cluster of 32190
deficiencies has been substantially corrected. The order shall 32191
take effect and the facility's participation shall terminate on 32192
the twentieth day after the exit interview, unless the facility 32193
has substantially corrected the deficiency or cluster of 32194
deficiencies that constituted a severity level four finding or did 32195
not receive notice from the department of job and family services32196
health care administration or contracting agency within five days 32197
after the exit interview. In the latter case, the order shall take32198
effect and the facility's participation shall terminate on the32199
fifteenth day after the facility received the order.32200

       (C) If the department of health cites a deficiency or cluster 32201
of deficiencies pursuant to division (E) of section 5111.4132202
5164.56 of the Revised Code that constituted a severity level four 32203
finding, the department of job and family serviceshealth care 32204
administration or a contracting agency shall, subject to section 32205
5111.565164.72 of the Revised Code, impose a fine. The fine shall 32206
be in effect for a period equal to the number of days the 32207
deficiency or cluster of deficiencies existed at the facility.32208

       Sec. 5111.47.        Sec. 5164.63.  If the department of health cites a32209
deficiency, or cluster of deficiencies, that was not substantially 32210
corrected before a survey and constitutes a severity level three 32211
and scope level three or four finding, the department of job and 32212
family serviceshealth care administration or a contracting agency 32213
may, subject to sections 5111.555164.71 and 5111.565164.72 of 32214
the Revised Code, impose one or more of the following remedies:32215

       (A) Do either of the following:32216

       (1) Issue an order denying payment to the facility under the 32217
medical assistancemedicaid program for all medicaid eligible32218
residents admitted after the effective date of the order;32219

       (2) Impose a fine.32220

       (B) Issue an order denying payment to the facility under the 32221
medical assistancemedicaid program for medicaid eligible 32222
residents admitted after the effective date of the order who have 32223
certain diagnoses or special care needs specified by the 32224
department or agency;32225

       (C) Issue an order requiring the facility to correct the32226
deficiency or cluster of deficiencies under the plan of correction 32227
submitted by the facility and approved by the department of health 32228
under section 5111.435164.59 of the Revised Code.32229

       Sec. 5111.48.        Sec. 5164.64.  (A) If the department of health cites 32230
a deficiency, or cluster of deficiencies, that was not32231
substantially corrected before a survey and constitutes a severity 32232
level three and scope level two finding, the department of job and32233
family serviceshealth care administration or a contracting agency 32234
may, subject to sections 5111.555164.71 and 5111.565164.72 of 32235
the Revised Code, impose one or more of the following remedies:32236

       (1) Do either of the following:32237

       (a) Issue an order denying payment to the facility under the 32238
medical assistancemedicaid program for all medicaid eligible32239
residents admitted after the effective date of the order;32240

       (b) Impose a fine.32241

       (2) Issue an order denying payment to the facility under the 32242
medical assistancemedicaid program for medicaid eligible 32243
residents admitted after the effective date of the order who have 32244
certain diagnoses or special care needs specified by the 32245
department or agency;32246

       (3) Issue an order requiring the facility to correct the32247
deficiency or cluster of deficiencies under the plan of correction 32248
proposed by the facility and approved by the department of health 32249
under section 5111.435164.59 of the Revised Code.32250

       (B) If the department of health cites a deficiency, or32251
cluster of deficiencies, that was not substantially corrected32252
before a survey and constitutes a severity level three and scope32253
level one finding, the department of job and family services32254
health care administration or a contracting agency may, subject to 32255
sections 5111.555164.71 and 5111.565164.72 of the Revised Code, 32256
impose one or more of the following remedies:32257

       (1) Impose a fine;32258

       (2) Issue an order denying payment to the facility under the 32259
medical assistancemedicaid program for medicaid eligible 32260
residents admitted after the effective date of the order who have 32261
certain diagnoses or special care needs specified by the 32262
department or agency;32263

       (3) Issue an order requiring the facility to correct the32264
deficiency or cluster of deficiencies under the plan of correction 32265
proposed by the facility and approved by the department of health 32266
under section 5111.435164.59 of the Revised Code.32267

       (C) If the department of health cites a deficiency, or32268
cluster of deficiencies, that was not substantially corrected32269
before a survey and constitutes a severity level two and a scope32270
level three or four finding, the department of job and family 32271
serviceshealth care administration or a contracting agency may, 32272
subject to sections 5111.555164.71 and 5111.565164.72 of the 32273
Revised Code, impose one or more of the following remedies:32274

       (1) Impose a fine;32275

       (2) Issue an order denying payment to the facility under the 32276
medical assistancemedicaid program for medicaid eligible 32277
residents admitted after the effective date of the order who have 32278
certain diagnoses or special care needs specified by the 32279
department or agency;32280

       (3) Issue an order requiring the facility to correct the32281
deficiency or cluster of deficiencies under the plan of correction 32282
submitted by the facility and approved by the department of health 32283
under section 5111.435164.59 of the Revised Code.32284

       (D) If the department of health cites a deficiency, or32285
cluster of deficiencies, that was not substantially corrected32286
before a survey, constitutes a severity level two and scope level32287
one or two finding, and is a repeat finding, the department of job 32288
and family serviceshealth care administration or a contracting 32289
agency may issue an order requiring the facility to correct the 32290
deficiency or cluster of deficiencies under the plan of correction 32291
submitted by the facility and approved by the department of health 32292
under section 5111.435164.59 of the Revised Code.32293

       (E) If the department of health cites a deficiency, or32294
cluster of deficiencies, that was not substantially corrected32295
before a survey and constitutes a severity level one and scope32296
level three or four finding, the department of job and family 32297
serviceshealth care administration or a contracting agency may 32298
issue an order requiring the facility to correct the deficiency or 32299
cluster of deficiencies under the plan of correction submitted by 32300
the facility and approved by the department of health under 32301
section 5111.435164.59 of the Revised Code.32302

       (F) If the department of health cites a deficiency, or32303
cluster of deficiencies, that was not substantially corrected32304
before a survey, constitutes a severity level one and scope level32305
two finding, and is a repeat finding, the department of job and 32306
family serviceshealth care administration or a contracting agency 32307
may issue an order requiring the facility to correct the 32308
deficiency or cluster of deficiencies under the plan of correction 32309
submitted by the facility and approved by the department of health 32310
under section 5111.435164.59 of the Revised Code.32311

       Sec. 5111.49.        Sec. 5164.65.  (A) In determining which remedies to 32312
impose under section 5111.465164.62, 5111.475164.63, or 5111.4832313
5164.64 of the Revised Code, including whether a fine should be 32314
imposed, the department of job and family serviceshealth care 32315
administration or a contracting agency shall do both of the32316
following:32317

       (1) Impose the remedies that are most likely to achieve32318
correction of deficiencies, encourage sustained compliance with32319
certification requirements, and protect the health, safety, and32320
rights of facility residents, but that are not directed at32321
punishment of the facility;32322

       (2) Consider all of the following:32323

       (a) The presence or absence of immediate jeopardy;32324

       (b) The relationships of groups of deficiencies to each32325
other;32326

       (c) The facility's history of compliance with certification 32327
requirements generally and in the specific area of the deficiency 32328
or deficiencies;32329

       (d) Whether the deficiency or deficiencies are directly32330
related to resident care;32331

       (e) The corrective, long-term compliance, resident32332
protective, and nonpunitive outcomes sought by the department or32333
agency;32334

       (f) The nature, scope, and duration of the noncompliance with 32335
certification requirements;32336

       (g) The existence of repeat deficiencies;32337

       (h) The category of certification requirements with which the 32338
facility is out of compliance;32339

       (i) Any period of noncompliance with certification32340
requirements that occurred between two certifications by the32341
department of health that the facility was in compliance with32342
certification requirements;32343

       (j) The facility's degree of culpability;32344

       (k) The accuracy, extent, and availability of facility32345
records;32346

       (l) The facility's financial condition, exclusive of any32347
moneys donated to a facility that is an organization described in32348
subsection 501(c)(3) and is tax exempt under subsection 501(a) of32349
the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A.32350
1;32351

       (m) Any adverse effect that the action or fine would have on 32352
the health and safety of facility residents;32353

       (n) If the noncompliance that resulted in the citation of a 32354
deficiency or cluster of deficiencies existed before a change in 32355
ownership of the facility, whether the new owner or owners have 32356
had sufficient time to correct the noncompliance.32357

       (B) Whenever the department or agency imposes remedies under 32358
section 5111.465164.62, 5111.475164.63, or 5111.485164.64 of 32359
the Revised Code, it shall provide a written statement to the 32360
nursing facility that specifies all of the following:32361

       (1) The effective date of each remedy;32362

       (2) The deficiency or cluster of deficiencies for which each 32363
remedy is imposed;32364

       (3) The severity and scope of the deficiency or cluster of32365
deficiencies;32366

       (4) The rationale, including all applicable factors specified 32367
in division (A) of this section, for imposing the remedies.32368

       Sec. 5111.50.        Sec. 5164.66.  At the time the department of job and 32369
family serviceshealth care administration or a contracting32370
agency, under section 5111.455164.61, 5111.465164.62, or 5111.5132371
5164.67 of the Revised Code, issues an order terminating a nursing 32372
facility's participation in the medical assistancemedicaid32373
program, the department or agency may also impose a fine, in32374
accordance with sections 5111.465164.62 to 5111.485164.64 and 32375
5111.565164.72 of the Revised Code, to be collected in the event 32376
the termination order does not take effect. The department or 32377
agency shall not collect this fine if the termination order takes32378
effect.32379

       Sec. 5111.51.        Sec. 5164.67.  (A) If the department of health finds32380
during a survey that an emergency exists at a nursing facility, as 32381
the result of a deficiency or cluster of deficiencies that creates 32382
immediate jeopardy, the department of job and family services32383
health care administration or a contracting agency shall impose 32384
one or more of the remedies described in division (A)(1) of this 32385
section and, in addition, may take one or both of the actions 32386
described in division (A)(2) of this section.32387

       (1) The department or agency shall impose one or more of the 32388
following remedies:32389

       (a) Appoint, subject to the continuing consent of the32390
provider, a temporary manager of the facility;32391

       (b) Apply to the common pleas court of the county in which32392
the facility is located for a temporary restraining order,32393
preliminary injunction, or such other injunctive or equitable32394
relief as is necessary to close the facility, transfer one or more 32395
residents to other nursing facilities or other appropriate care 32396
settings, or otherwise eliminate the condition of immediate32397
jeopardy. If the court grants such an order, injunction, or32398
relief, it may appoint a special master empowered to implement the 32399
court's judgment under the court's direct supervision.32400

       (c) Issue an order terminating the facility's participation 32401
in the medical assistance program;32402

       (d) Regardless of whether the provider consents, appoint a32403
temporary manager of the facility.32404

       (2) The department or agency may do one or both of the32405
following:32406

       (a) Issue an order denying payment to the facility for all32407
medicaid eligible residents admitted after the effective date of32408
the order;32409

       (b) Impose remedies under sections 5111.465164.62 to 5111.4832410
5164.64 of the Revised Code appropriate to the severity and scope 32411
of the deficiency or cluster of deficiencies, except that the 32412
department or agency shall not impose a fine for the same 32413
deficiency for which the department or agency has issued an order 32414
under division (A)(2)(a) of this section.32415

       (B) If the department of health, department of job and family 32416
serviceshealth care administration, or a contracting agency finds 32417
on the basis of a survey or other visit to the facility by 32418
representatives of that department or agency that an emergency 32419
exists at a facility that is not the result of a deficiency or 32420
cluster of deficiencies that constitutes immediate jeopardy, the 32421
department of job and family serviceshealth care administration32422
or contracting agency may do either of the following:32423

       (1) Appoint, subject to the continuing consent of the32424
provider, a temporary manager of the facility;32425

       (2) Apply to the common pleas court of the county in which32426
the facility is located for a temporary restraining order,32427
preliminary injunction, or such other injunctive or equitable32428
relief as is necessary to close the facility, transfer one or more 32429
residents to other nursing facilities or other appropriate care 32430
settings, or otherwise eliminate the emergency. If the court 32431
grants such an order, injunction, or relief, it may appoint a 32432
special master empowered to implement the court's judgment under 32433
the court's direct supervision.32434

       (C)(1) Prior to acting under division (A)(1)(b), (c), (d), or 32435
(2), or (B)(2) of this section, the department of job and family32436
serviceshealth care administration or contracting agency shall 32437
give written notice to the facility specifying all of the 32438
following:32439

       (a) The nature of the emergency, including the nature of any 32440
deficiency or deficiencies that caused the emergency;32441

       (b) The nature of the action the department or agency intends 32442
to take unless the department of health determines that the 32443
facility, in the absence of state intervention, possesses the32444
capacity to eliminate the emergency;32445

       (c) The rationale for taking the action.32446

       (2) If the department of health determines that the facility 32447
does not possess the capacity to eliminate the emergency in the 32448
absence of state intervention, the department of job and family32449
serviceshealth care administration or contracting agency may 32450
immediately take action under division (A) or (B) of this section. 32451
If the department of health determines that the facility possesses 32452
the capacity to eliminate the emergency, the department of job and 32453
family serviceshealth care administration or contracting agency 32454
shall direct the facility to eliminate the emergency within five 32455
days after the facility's receipt of the notice. At the end of the 32456
five-day period, the department of health shall conduct a 32457
follow-up survey that focuses on the emergency. If the department 32458
of health determines that the facility has eliminated the 32459
emergency within the time period, the department of job and family32460
serviceshealth care administration or contracting agency shall 32461
not act under division (A)(1)(b), (c), (d), or (2)(a), or (B)(2) 32462
of this section. If the department of health determines that the 32463
facility has failed to eliminate the emergency within the five-day 32464
period, the department of job and family services or contracting 32465
agency shall take appropriate action under division (A)(1)(b), 32466
(c), (d), or (2), or (B)(2) of this section.32467

       (3) Until the written notice required by division (C)(1) of 32468
this section is actually delivered, no action taken by the32469
department of job and family serviceshealth care administration32470
or contracting agency under division (A)(1)(b), (c), (d), or (2), 32471
or (B)(2) of this section shall have any legal effect. In addition 32472
to the written notice, the department of health survey team shall 32473
give oral notice to the facility, at the time of the survey, 32474
concerning any recommendations the survey team intends to make 32475
that could form the basis of a determination that an emergency 32476
exists.32477

       (D) The department of job and family serviceshealth care 32478
administration or contracting agency shall deliver a written order 32479
issued under division (A)(1) of this section terminating a nursing 32480
facility's participation in the medical assistancemedicaid32481
program to the facility within five days after the exit interview. 32482
If the facility alleges, at any time prior to the later of the 32483
twentieth day after the exit interview or the fifteenth day after 32484
it receives the order, that the condition of immediate jeopardy 32485
for which the order was issued has been eliminated, the department 32486
of health shall conduct a follow-up survey to determine whether 32487
the immediate jeopardy has been eliminated. The order shall take 32488
effect and the facility's participation shall terminate on the 32489
twentieth day after the exit interview, unless the facility has 32490
eliminated the immediate jeopardy or did not receive notice from 32491
the department of job and family serviceshealth care 32492
administration or contracting agency within five days after the 32493
exit interview. In the latter case, the order shall take effect 32494
and the facility's participation shall terminate on the fifteenth 32495
day after the facility received the order.32496

       (E) Any action taken by the department of job and family 32497
serviceshealth care administration or a contracting agency under 32498
division (A)(1)(c), (d), or (2)(a) of this section is subject to 32499
appeal under Chapter 119. of the Revised Code, except that the 32500
department or agency may take such action prior to and during the 32501
pendency of any proceeding under that chapter. No action taken by 32502
a facility under division (C) of this section to eliminate an 32503
emergency cited by the department of health shall be considered an 32504
admission by the facility of the existence of an emergency.32505

       Sec. 5111.52.        Sec. 5164.68.  (A) As used in this section:32506

       (1) "Provider agreement" means a contract between the32507
department of job and family serviceshealth care administration32508
and a nursing facility for the provision of nursing facility 32509
services under the medical assistancemedicaid program.32510

       (2) "Terminating" includes not renewing.32511

       (B) A nursing facility's participation in the medical32512
assistancemedicaid program shall be terminated under sections 32513
5111.355164.50 to 5111.625164.78 of the Revised Code as follows:32514

       (1) If the department of job and family serviceshealth care 32515
administration is terminating the facility's participation, it 32516
shall issue an order terminating the facility's provider 32517
agreement.32518

       (2) If the department of health, acting as a contracting32519
agency, is terminating the facility's participation, it shall32520
issue an order terminating certification of the facility's32521
compliance with certification requirements. When the department of 32522
health terminates certification, the department of job and family32523
serviceshealth care administration shall terminate the facility's 32524
provider agreement. The department of job and family services32525
health care administration is not required to provide an32526
adjudication hearing when it terminates a provider agreement32527
following termination of certification by the department of32528
health.32529

       (3) If a state agency other than the department of health,32530
acting as a contracting agency, is terminating the facility's32531
participation, it shall notify the department of job and family32532
serviceshealth care administration, and the department of job and 32533
family serviceshealth care administration shall issue an order32534
terminating the facility's provider agreement. The contracting32535
agency shall conduct any administrative proceedings concerning the 32536
order.32537

       (C) If the following conditions are met, the department of 32538
job and family serviceshealth care administration may make 32539
medical assistancemedicaid payments to a nursing facility for a 32540
period not exceeding thirty days after the effective date of 32541
termination under sections 5111.355164.50 to 5111.625164.78 of 32542
the Revised Code of the facility's participation in the medical 32543
assistancemedicaid program:32544

       (1) The payments are for medicaid eligible residents admitted 32545
to the facility prior to the effective date of the termination;32546

       (2) The provider is making reasonable efforts to transfer32547
medicaid eligible residents to other care settings.32548

       The period during which payments may be made under this32549
division begins on the later of the effective date of the32550
termination or, if the facility has appealed a termination order,32551
the date of issuance of the adjudication order upholding32552
termination.32553

       Sec. 5111.53.        Sec. 5164.69.  (A) Whenever a nursing facility is 32554
closed under sections 5111.355164.50 to 5111.625164.78 of the 32555
Revised Code, the department of job and family serviceshealth 32556
care administration or contracting agency shall arrange for the 32557
safe and orderly transfer of all residents, including residents 32558
who are not medicaid eligible residents, to other appropriate care 32559
settings. Whenever a facility's participation in the medical 32560
assistancemedicaid program is terminated under sections 5111.3532561
5164.50 to 5111.625164.78 of the Revised Code, the department or 32562
agency shall arrange for the safe and orderly transfer of all 32563
medicaid eligible residents or, if the termination results in the 32564
closure of the facility, of all residents. The provider and all 32565
persons involved in the facility's operation shall cooperate with 32566
and assist in the transfer of residents.32567

       (B) After a nursing facility's participation in the medical 32568
assistancemedicaid program is terminated under section 5111.4532569
5164.61, 5111.465164.62, 5111.515164.67, or 5111.585164.74 of 32570
the Revised Code, the department of job and family serviceshealth 32571
care administration or contracting agency may appoint a temporary32572
manager subject to the continuing consent of the provider, or may32573
apply to the common pleas court of the county in which the32574
facility is located for such injunctive relief as is necessary for 32575
the appointment of a special master, to ensure the transfer of 32576
medicaid eligible residents to other appropriate care settings32577
and, if applicable, the orderly closure of the facility.32578

       Sec. 5111.54.        Sec. 5164.70.  (A) A temporary manager of a nursing32579
facility appointed by the department of job and family services32580
health care administration or a contracting agency under sections 32581
5111.355164.50 to 5111.625164.78 of the Revised Code shall meet 32582
all of the following qualifications:32583

       (1) Be licensed as a nursing home administrator under Chapter 32584
4751. of the Revised Code;32585

       (2) Have demonstrated competence as a nursing home32586
administrator;32587

       (3) Have had no disciplinary action taken against the 32588
temporary manager by any licensing board or professional society 32589
in this state.32590

       (B) The salary of a temporary manager or special master32591
appointed under sections 5111.355164.50 to 5111.625164.78 of the 32592
Revised Code shall be paid by the facility and set by the 32593
department of job and family serviceshealth care administration32594
or contracting agency, in the case of a temporary manager, or by 32595
the court, in the case of a special master, at a rate not to 32596
exceed the maximum allowable compensation for an administrator 32597
under the medical assistancemedicaid program. The extent to which 32598
this compensation is allowable under the medical assistance32599
medicaid program is subject to and limited by this chapter and32600
rules of the department.32601

       Subject to division (C) of this section, any costs incurred32602
on behalf of a nursing facility by a temporary manager or special32603
master appointed under sections 5111.355164.50 to 5111.625164.7832604
of the Revised Code shall be paid by the facility. The 32605
allowability of these costs under the medical assistancemedicaid32606
program shall be subject to and governed by this chapter and the 32607
rules of the department. This division does not prohibit a 32608
facility from applying for or receiving any waiver of cost 32609
ceilings available under rules of the department.32610

       (C) No temporary manager or special master appointed under32611
sections 5111.355164.50 to 5111.625164.78 of the Revised Code 32612
shall enter into any employment contract on behalf of a facility, 32613
or purchase any capital goods using facility funds totaling more 32614
than ten thousand dollars, unless the temporary manager or special 32615
master has obtained prior approval for the contract or purchase 32616
from either the provider or the court.32617

       (D)(1) A temporary manager appointed for a nursing facility 32618
under section 5111.465164.62 of the Revised Code is hereby32619
vested, subject to division (C) of this section, with the legal32620
authority necessary to correct any deficiency or cluster of32621
deficiencies at a facility, bring the facility into compliance32622
with certification requirements, and otherwise ensure the health32623
and safety of the residents.32624

       (2) A temporary manager appointed under section 5111.5132625
5164.67 of the Revised Code is hereby vested, subject to division 32626
(C) of this section, with the authority necessary to eliminate the32627
emergency, bring the facility into compliance with certification32628
requirements, and otherwise ensure the health and safety of the32629
residents.32630

       (3) A temporary manager appointed under section 5111.5332631
5164.69 of the Revised Code is hereby vested, subject to division 32632
(C) of this section, with the authority necessary to ensure the 32633
transfer of medicaid eligible residents to other appropriate care 32634
settings and, if applicable, the orderly closure of the facility, 32635
and to otherwise ensure the health and safety of the residents.32636

       (E) Prior to acting under division (A)(1)(b) or (2)(b) of32637
section 5111.465164.62 of the Revised Code to appoint a temporary32638
manager or apply for a special master, the department of job and 32639
family serviceshealth care administration or contracting agency 32640
shall order the facility to substantially correct the deficiency 32641
or deficiencies within five days after receiving the statement and 32642
inform the facility, in the statement it provides pursuant to 32643
division (B) of section 5111.495164.65 of the Revised Code, of 32644
the order and that it will not take that action unless the 32645
facility fails to substantially correct the deficiency or 32646
deficiencies within that five-day period. At the end of the 32647
five-day period, the department of health shall conduct a 32648
follow-up survey that focuses on the deficiency or deficiencies. 32649
If the department of health determines that the facility has 32650
substantially corrected the deficiency or deficiencies within that 32651
time, the department of job and family serviceshealth care 32652
administration or contracting agency shall not appoint a temporary 32653
manager or apply for a special master. If the department of health 32654
determines that the facility has failed to substantially correct 32655
the deficiency or deficiencies within that time, the department of 32656
job and family serviceshealth care administration or contracting 32657
agency may proceed with appointment of the temporary manager or 32658
application for a special master. Until the statement required 32659
under division (B) of section 5111.495164.65 of the Revised Code 32660
is actually delivered, no action taken by the department or agency 32661
to appoint a temporary manager or apply for a temporary manager 32662
under division (A)(1)(b) or (2)(b) of section 5111.465164.62 of 32663
the Revised Code shall have any legal effect. No action taken by a 32664
facility under this division to substantially correct a deficiency 32665
or deficiencies shall be considered an admission by the facility 32666
of the existence of a deficiency or deficiencies.32667

       (F) Appointment of a temporary manager under division32668
(A)(1)(b) or (2)(b) of section 5111.465164.62 or division 32669
(A)(1)(d) of section 5111.515164.67 of the Revised Code shall 32670
expire at the end of the seventh day following the appointment. If 32671
the department of job and family serviceshealth care 32672
administration or contracting agency finds that the deficiency or32673
deficiencies that prompted the appointment under division32674
(A)(1)(b) or (2)(b) of section 5111.465164.62 of the Revised Code 32675
cannot be substantially corrected, or the condition of immediate32676
jeopardy that prompted the appointment under division (A)(1)(d) of 32677
section 5111.515164.67 of the Revised Code cannot be eliminated,32678
prior to the expiration of the appointment, it may take one of the 32679
following actions:32680

       (1) Appoint, subject to the continuing consent of the32681
provider, a temporary manager for the facility;32682

       (2) Apply to the common pleas court of the county in which32683
the facility is located for an order appointing a special master32684
who, under the authority and direct supervision of the court and32685
subject to divisions (B) and (C) of this section, may take such32686
additional actions as are necessary to correct the deficiency or32687
deficiencies or eliminate the condition of immediate jeopardy and32688
bring the facility into compliance with certification32689
requirements.32690

       (G) The court, on finding that the deficiency or deficiencies 32691
for which a special master was appointed under division (F)(2) of 32692
this section or division (A)(1)(b) or (2)(b) of section 5111.4632693
5164.62 of the Revised Code has been substantially corrected, or 32694
the emergency for which a special master was appointed under 32695
division (F)(2) of this section or division (A)(1)(b) or (B)(2) of 32696
section 5111.515164.67 of the Revised Code has been eliminated, 32697
that the facility has been brought into compliance with 32698
certification requirements, and that the provider has established 32699
the management capability to ensure continued compliance with the 32700
certification requirements, shall immediately terminate its 32701
jurisdiction over the facility and return control and management 32702
of the facility to the provider. If the deficiency or deficiencies 32703
cannot be substantially corrected, or the emergency cannot be 32704
eliminated practicably within a reasonable time following 32705
appointment of the special master, the court may order the special 32706
master to close the facility and transfer all residents to other 32707
nursing facilities or other appropriate care settings.32708

       Sec. 5111.55.        Sec. 5164.71.  (A) An order issued under section 32709
5111.465164.62, 5111.475164.63, 5111.485164.64, 5111.5132710
5164.67, or 5111.575164.73 of the Revised Code denying payment to 32711
a nursing facility for all medicaid eligible residents admitted 32712
after its effective date, or an order issued under section 5111.4632713
5164.62, 5111.475164.63, or 5111.485164.64 of the Revised Code 32714
denying payment to a nursing facility for medicaid eligible 32715
residents admitted after the effective date of the order who have 32716
specified diagnoses or special care needs, shall also apply to 32717
individuals admitted to the facility on and after the effective 32718
date of the order who are not medicaid eligible residents but 32719
become medicaid eligible residents after admission. Such an order 32720
shall not apply to any of the following:32721

       (1) An individual who was a medicaid eligible resident of the 32722
facility on the day immediately preceding the effective date of 32723
the order and continues to be a medicaid eligible resident on and 32724
after that date;32725

       (2) An individual who was a resident of the facility on the 32726
day immediately preceding the effective date of the order,32727
continues to be a resident on and after that date, and becomes32728
medicaid eligible on or after that date;32729

       (3) An individual who was a medicaid eligible resident of the 32730
facility prior to the effective date of the order, is temporarily 32731
absent from the facility on that or a subsequent date due to 32732
hospitalization or participation in therapeutic programs outside 32733
the facility, and chooses to return to the facility;32734

       (4) An individual who was a resident of the facility prior to 32735
the effective date of the order, is temporarily absent from the 32736
facility on that or a subsequent date due to hospitalization or 32737
participation in therapeutic programs outside the facility,32738
becomes medicaid eligible on or after that date, and chooses to32739
return to the facility.32740

       (B) An order issued under section 5111.465164.62 of the 32741
Revised Code denying payment to a nursing facility for all 32742
medicaid eligible residents admitted after its effective date, or 32743
denying payment to a facility for medicaid eligible residents 32744
admitted after the effective date of the order who have specified32745
diagnoses or special care needs shall not take effect prior to the 32746
fifth day after the order is delivered to the facility. Such an 32747
order issued under section 5111.475164.63 or 5111.485164.64 of 32748
the Revised Code shall not take effect prior to the twentieth day 32749
after it is delivered to the facility.32750

       (C) No nursing facility that has received an order under32751
section 5111.465164.62, 5111.475164.63, 5111.485164.64, 5111.5132752
5164.67, or 5111.575164.73 of the Revised Code denying payment 32753
for all new admissions of medicaid eligible residents shall admit 32754
a medicaid eligible resident on or after the effective date of the 32755
order, unless the resident is described in division (A)(3) or (4) 32756
of this section, until the order is terminated pursuant to this 32757
section. No nursing facility that has received an order under 32758
section 5111.465164.62, 5111.475164.63, or 5111.485164.64 of 32759
the Revised Code denying payment to a nursing facility for new 32760
admissions of medicaid eligible residents with specified diagnoses 32761
or special care needs shall admit such a resident on or after the 32762
effective date of the order, unless the resident is described in 32763
division (A)(3) or (4) of this section, until the order is 32764
terminated pursuant to this section.32765

       (D) In the case of an order imposed under division (B) of32766
section 5111.575164.73 of the Revised Code, the department of 32767
health care administration or contracting agency shall appoint 32768
monitors in accordance with section 5111.445164.60 of the Revised 32769
Code to conduct on-site monitoring.32770

       (E)(1) A facility may give written notice to the department 32771
of health whenever any of the following apply:32772

       (a) With respect to an order denying payment issued under32773
section 5111.465164.62, 5111.475164.63, or 5111.485164.64 of 32774
the Revised Code, either of the following is the case:32775

       (i) The facility has completed implementation of the plan of 32776
correction it submitted under section 5111.435164.59 of the 32777
Revised Code and substantially corrected all deficiencies for 32778
which the order was issued.32779

       (ii) The facility has reduced the severity or scope of all of 32780
the deficiencies to a level at which sections 5111.465164.62 to32781
5111.485164.64 of the Revised Code do not authorize the order.32782

       (b) With respect to an order denying payment issued under32783
section 5111.515164.67 of the Revised Code, the facility has 32784
eliminated the immediate jeopardy.32785

       (c) With respect to an order denying payment issued under32786
division (A) of section 5111.575164.73 of the Revised Code, the 32787
facility has completed implementation of the plan of correction it32788
submitted under section 5111.435164.59 of the Revised Code and32789
substantially corrected all deficiencies for which the order was32790
issued.32791

       (d) With respect to an order denying payment issued under32792
division (B) of section 5111.575164.73 of the Revised Code, both 32793
of the following are the case:32794

       (i) The facility has completed implementation of the plan of 32795
correction it submitted under section 5111.435164.59 of the 32796
Revised Code and substantially corrected all deficiencies for 32797
which the order was issued.32798

       (ii) The facility is in compliance with certification32799
requirements and has provided adequate assurance that it will32800
remain in compliance with them.32801

       (2) Within ten working days after it receives the notice32802
under division (E)(1) of this section, the department of health32803
shall conduct a follow-up survey that focuses on the cited32804
deficiency or deficiencies, unless the department is able to32805
determine, on the basis of documentation provided by the facility, 32806
that the facility has completed the applicable action described in 32807
divisions (E)(1)(a) to (d) of this section. If the department of 32808
health makes that determination on the basis of the documentation, 32809
the department of job and family serviceshealth care 32810
administration or contracting agency shall terminate the order 32811
denying payment as of the date the facility completed the 32812
applicable action, as subsequently verified by the department of 32813
health. If the department of health conducts a follow-up survey, 32814
the department of job and family serviceshealth care 32815
administration or contracting agency shall terminate the order 32816
denying payment as of the date the department of health makes the32817
determination that the facility completed the applicable action.32818

       (F) The department of job and family serviceshealth care 32819
administration or contracting agency shall provide public notice 32820
implementing an order under section 5111.465164.62, 5111.4732821
5164.63, 5111.485164.64, 5111.515164.67, or 5111.575164.73 of 32822
the Revised Code denying payment to a nursing facility under the 32823
medical assistancemedicaid program for all medicaid eligible 32824
residents by publishing in a newspaper of general circulation in 32825
the county in which the facility is located an announcement 32826
stating: "By order of the (Ohio Department of Job and Family 32827
ServicesHealth Care Administration or name of contracting32828
agency), effective on and after (effective date of order), (name32829
of facility) is no longer authorized to admit Medicaid eligible32830
residents." Immediately following termination of any such order,32831
the department or agency shall publish in a newspaper of general32832
circulation in the county in which the facility is located an32833
announcement stating: "By order of the (Ohio Department of Job and 32834
Family ServicesHealth Care Administration or name of contracting 32835
agency), effective on and after (effective date of termination), 32836
(name of facility) is hereby authorized to admit Medicaid eligible 32837
residents." Neither the department nor the contracting agency 32838
shall issue public notice of an order under section 5111.4632839
5164.62, 5111.475164.63, or 5111.485164.64 of the Revised Code 32840
denying payment to a nursing facility for medicaid eligible 32841
residents with specified diagnoses or special care needs; public 32842
notice is not required for such an order to take effect.32843

       (G) A facility that complies with division (E) of this32844
section shall not be considered to have admitted to the existence32845
of the deficiency that constitutes the basis of the department's32846
or agency's order.32847

       Sec. 5111.56.        Sec. 5164.72.  (A) As used in this section, 32848
"certified beds" means beds certified under Title XVIII or XIX of 32849
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, 32850
as amendedthe medicare or medicaid program.32851

       (B) If the department of job and family serviceshealth care 32852
administration or a contracting agency imposes a fine on a nursing 32853
facility under section 5111.465164.62, 5111.475164.63, or 32854
5111.485164.64 of the Revised Code, it may impose one or more of 32855
the following:32856

       (1) One hundred sixty per cent of the amount calculated under 32857
division (C) of this section for any deficiency or cluster of 32858
deficiencies that constitutes a severity level four and scope32859
level four finding;32860

       (2) One hundred forty per cent of the amount calculated under 32861
division (C) of this section for any deficiency or cluster of 32862
deficiencies that constitutes a severity level four and scope32863
level three finding;32864

       (3) One hundred twenty per cent of the amount calculated32865
under division (C) of this section for any deficiency or cluster32866
of deficiencies that constitutes a severity level four and scope32867
level two finding;32868

       (4) The amount calculated under division (C) of this section 32869
for any deficiency or cluster of deficiencies that constitutes a 32870
severity level four and scope level one finding or any deficiency 32871
or cluster of deficiencies that constitutes a severity level three 32872
and scope level four finding;32873

       (5) Ninety per cent of the amount calculated under division 32874
(C) of this section for any deficiency or cluster of deficiencies 32875
that constitutes a severity level three and scope level three 32876
finding;32877

       (6) Eighty per cent of the amount calculated under division 32878
(C) of this section for any deficiency or cluster of deficiencies 32879
that constitutes a severity level three and scope level two 32880
finding;32881

       (7) Seventy per cent of the amount calculated under division 32882
(C) of this section for any deficiency or cluster of deficiencies 32883
that constitutes a severity level three and scope level one 32884
finding;32885

       (8) Fifty per cent of the amount calculated under division32886
(C) of this section for any deficiency or cluster of deficiencies32887
that constitutes a severity level two and scope level four32888
finding;32889

       (9) Forty per cent of the amount calculated under division32890
(C) of this section for any deficiency or cluster of deficiencies32891
that constitutes a severity level two and scope level three32892
finding.32893

       (C) The amount subject to division (B) of this section shall 32894
be the product of multiplying two dollars and fifty cents for each 32895
day the fine is in effect by the total number of licensed nursing 32896
home beds or certified beds, whichever is greater, in the facility 32897
as of the date the deficiency or cluster of deficiencies that is 32898
the reason for the fine was cited.32899

       (D)(1) The department of job and family serviceshealth care 32900
administration or contracting agency shall not impose on a 32901
facility, at any one time, more than four fines as a result of any 32902
one survey.32903

       (2) The department of job and family serviceshealth care 32904
administration or contracting agency shall not impose more than 32905
one fine based on a deficiency or cluster of deficiencies. 32906
However, if the department of health, in a follow-up or other 32907
subsequent survey, finds a change in the scope or severity of the 32908
deficiency or cluster of deficiencies, the department of job and 32909
family serviceshealth care administration or contracting agency 32910
may increase or decrease the fine in accordance with division (B) 32911
of this section to reflect the change in scope or severity. The32912
department or agency shall give the facility written notice of the 32913
change in the amount of the fine. The change shall take effect on 32914
the date the follow-up or other subsequent survey is completed.32915

       If the department of health finds that a deficiency is a32916
repeat deficiency, the department of job and family services32917
health care administration or contracting agency may impose a fine 32918
that is one hundred per cent greater than the fine specified in 32919
division (B) of this section for the deficiency.32920

       (E) The total amount of fines the department of job and 32921
family serviceshealth care administration or contracting agency 32922
may impose on a facility in a single calendar year shall not 32923
exceed five hundred dollars for each licensed nursing home bed or 32924
certified bed, whichever is greater in number, in the facility.32925

       (F)(1) Except as provided in division (F)(2) of this section, 32926
the department of job and family serviceshealth care 32927
administration or contracting agency shall not impose a fine under 32928
section 5111.465164.62, 5111.475164.63, or 5111.485164.64 of 32929
the Revised Code if the deficiency or cluster of deficiencies is 32930
substantially corrected within twenty days after the nursing 32931
facility receives the statement provided under division (B) of 32932
section 5111.495164.65 of the Revised Code. The department or 32933
agency shall inform the nursing facility in that statement that 32934
the fine will not be imposed if the deficiency or cluster of 32935
deficiencies is substantially corrected within the twenty-day 32936
period.32937

       (2) If a nursing facility has substantially corrected a32938
deficiency or cluster of deficiencies within six months after the32939
exit interview of a survey that was the basis for citing a32940
deficiency or cluster of deficiencies, but after correcting it has 32941
been cited for the same deficiency or cluster of deficiencies by 32942
the department of health on the basis of a subsequent survey32943
conducted during the remainder of the six-month period, the32944
department of job and family serviceshealth care administration32945
or contracting agency may impose a fine beginning on the date of 32946
the exit interview of the subsequent survey.32947

       (G) Whenever a facility believes that it has completed32948
implementation of the plan of correction it submitted under32949
section 5111.435164.59 of the Revised Code and substantially 32950
corrected the cited deficiency or cluster of deficiencies that is 32951
the basis for a fine, it may give written notice to that effect to 32952
the department of health. After receiving the notice, the 32953
department shall conduct a follow-up survey of the facility that 32954
focuses on the deficiency or cluster, unless the department is 32955
able to determine, on the basis of documentation provided by the32956
facility, that the facility has substantially corrected the32957
deficiency or cluster. If, based on the follow-up survey, the32958
department establishes that the facility had not completed32959
implementation of the plan of correction at the time the32960
department received the notice, any fine based on the deficiency32961
or cluster shall be doubled effective from the date the department 32962
received the notice. A facility that complies with this division 32963
shall not be considered to have admitted the existence of the 32964
deficiency or cluster that is the basis for the fine.32965

       (H) Except for a fine imposed under division (C) of section 32966
5111.465164.62 of the Revised Code and as provided in division32967
(F)(2) of this section, the department of job and family services32968
health care administration or contracting agency shall impose a 32969
fine only if the facility fails to give notice under division (G) 32970
of this section within twenty days after it receives the statement 32971
required by division (B) of section 5111.495164.65 of the Revised 32972
Code or if the department of health determines, based on a 32973
follow-up survey, that the deficiency or cluster of deficiencies 32974
for which the fine is proposed has not been substantially 32975
corrected within the twenty-day period. The fine shall be imposed 32976
effective on the twenty-first day after the facility receives the 32977
statement under division (B) of section 5111.495164.65 of the 32978
Revised Code. The fine shall remain in effect until the earliest 32979
of the following:32980

       (1) The date the department of health receives notice under 32981
division (G) of this section, unless the department determines, on 32982
the basis of a follow-up survey, that the deficiency or cluster of 32983
deficiencies that is the basis for the fine has not been 32984
substantially corrected as of that date;32985

       (2) The date on which the department of health makes a32986
determination, on the basis of a follow-up survey, that the32987
deficiency or cluster of deficiencies has been substantially32988
corrected;32989

       (3) The date the facility substantially corrected the32990
deficiency or cluster, as subsequently determined by the32991
department of health on the basis of documentation provided by the 32992
facility.32993

       (I) Any fine imposed by the department of job and family 32994
serviceshealth care administration or contracting agency under 32995
this section is subject to appeal under Chapter 119. of the 32996
Revised Code. If the facility does not request a hearing under 32997
Chapter 119. of the Revised Code and either pays or agrees in 32998
writing to pay the fine when payment becomes due under division 32999
(J) of this section, the department or agency shall reduce the 33000
fine by fifty per cent. The department or agency may compromise 33001
any claim for payment of a fine under sections 5111.355164.50 to 33002
5111.625164.78 of the Revised Code.33003

       (J) The department of job and family serviceshealth care 33004
administration or contracting agency shall collect interest on 33005
fines, at the rate per calendar month that equals one-twelfth of 33006
the rate per year prescribed by section 5703.47 of the Revised 33007
Code for the calendar year that includes the month for which the 33008
interest charge accrues. Payment of a fine is due, and interest 33009
begins to accrue on the unpaid fine or balance, on the 33010
thirty-first day after the department or agency issues a final 33011
adjudication order imposing the fine. If the deficiency or 33012
deficiencies on which the fine is based have not been corrected 33013
when the final adjudication order is issued, the payment is due, 33014
and interest begins to accrue on the unpaid fine or balance, on 33015
the thirty-first day after the deficiency or deficiencies are 33016
corrected and the department or agency mails a notice specifying 33017
the amount of the fine to the facility.33018

       (K) The department of job and family serviceshealth care 33019
administration or contracting agency shall collect fines and 33020
interest imposed under this section through one of the following 33021
means:33022

       (1) A lump sum payment from the provider;33023

       (2) Periodic payments for a period not to exceed twelve33024
months, in accordance with a schedule approved by the department33025
or agency;33026

       (3) Appropriately reducing the amounts of payments made to33027
the facility for care provided to medicaid eligible residents for33028
a period not to exceed twelve months following the date on which33029
payment of the fine becomes due under division (J) of this33030
section. An amount equal to the amount by which each payment is33031
reduced shall be deposited to the credit of the residents33032
protection fund in accordance with section 5111.625164.78 of the 33033
Revised Code.33034

       Sec. 5111.57.        Sec. 5164.73.  (A) The department of job and family33035
serviceshealth care administration or a contracting agency shall 33036
issue an order denying payment to a nursing facility for all 33037
medicaid eligible residents admitted to the facility on or after 33038
the effective date of the order, if the facility has failed to 33039
substantially correct within ninety days after the exit interview 33040
a deficiency or cluster of deficiencies in accordance with the 33041
plan of correction it submitted under section 5111.435164.59 of 33042
the Revised Code, as determined by the department of health on the 33043
basis of a follow-up survey.33044

       (B) The department of job and family serviceshealth care 33045
administration or contracting agency shall issue an order denying 33046
payment to a nursing facility for all medicaid eligible residents 33047
admitted to the facility on or after the effective date of the 33048
order, if during three consecutive standard surveys conducted 33049
after December 13, 1990, the department of health has found a 33050
condition of substandard care in a facility.33051

       (C) An order issued under division (A) or (B) of this section 33052
shall take effect on the later of the date the facility receives 33053
the order or the date the public notice required under division 33054
(F) of section 5111.555164.71 of the Revised Code is published.33055
The order is subject to appeal under Chapter 119. of the Revised33056
Code; however the order may take effect prior to or during the33057
pendency of any hearing under that chapter. In that case, the33058
department or agency shall provide the facility an opportunity for 33059
a hearing in accordance with section 5111.605164.76 of the 33060
Revised Code.33061

       Sec. 5111.58.        Sec. 5164.74.  (A) If a nursing facility notifies the33062
department of job and family serviceshealth care administration33063
or a contracting agency, at any time during the six-month period 33064
following the exit interview of a survey that was the basis for 33065
citing a deficiency or deficiencies, that the deficiency or 33066
deficiencies have been substantially corrected in accordance with 33067
the plan of correction submitted and approved under section 33068
5111.435164.59 of the Revised Code, the department of health 33069
shall conduct a follow-up survey to determine whether the 33070
deficiency or deficiencies have been substantially corrected in 33071
accordance with the plan.33072

       (B) The department of job and family serviceshealth care 33073
administration or a contracting agency shall terminate a nursing 33074
facility's participation in the medical assistancemedicaid33075
program whenever the facility has not substantially corrected, 33076
within six months after the exit interview of the survey on the 33077
basis of which it was cited, a deficiency or deficiencies in 33078
accordance with the plan of correction submitted under section 33079
5111.435164.59 of the Revised Code, as determined by the 33080
department of health on the basis of a follow-up survey.33081

       (C) Unless the facility has substantially corrected the33082
deficiency or deficiencies in accordance with the plan of33083
correction, as determined by the department of health on the basis 33084
of a follow-up survey, the department of job and family services33085
health care administration or contracting agency shall deliver to 33086
the facility, at least thirty days prior to the day that is six 33087
months after the exit interview, a written order terminating the 33088
facility's participation in the medical assistancemedicaid33089
program. The order shall take effect and the facility's 33090
participation shall terminate on the day that is six months after 33091
the exit interview. The order shall not take effect if, after it 33092
is delivered to the facility and prior to the effective date of 33093
the order, the department of health determines on the basis of a 33094
follow-up survey that the facility has corrected the deficiency or 33095
deficiencies.33096

       An order issued under this section is subject to appeal under 33097
Chapter 119. of the Revised Code; however, the order may take 33098
effect prior to or during the pendency of any hearing under that 33099
chapter. In that case, the department of job and family services33100
health care administration or contracting agency shall provide the 33101
facility an opportunity for a hearing in accordance with section 33102
5111.605164.76 of the Revised Code.33103

       (D) Except as provided in division (E) of this section,33104
whenever the department of job and family serviceshealth care 33105
administration or a contracting agency terminates a facility's 33106
participation in the medical assistancemedicaid program pursuant 33107
to this section, the provider shall repay the department the 33108
federal share of all payments made by the department to the 33109
facility under the medical assistancemedicaid program during the 33110
six-month period following the exit interview of the survey that 33111
was the basis for citing the deficiency or cluster of33112
deficiencies. The provider shall repay the department within33113
thirty days after the department repays to the federal government33114
the federal share of payments made to the facility during that33115
six-month period.33116

       (E) A provider is not required to repay the department of job 33117
and family serviceshealth care administration if either of the 33118
following is the case:33119

       (1) The facility has brought an appeal under Chapter 119. of 33120
the Revised Code of termination of its participation in the33121
medical assistancemedicaid program, except that the provider 33122
shall repay the department of job and family serviceshealth care 33123
administration within thirty days after the facility exhausts its 33124
right to appeal under that chapter.33125

       (2) The facility complied with the plan of correction33126
approved by the department of health and the obligation to repay33127
resulted from the department's failure to provide timely33128
verification to the United States department of health and human 33129
services of the facility's compliance with the plan of correction.33130

       (F) If a provider's obligation to repay the department of job 33131
and family serviceshealth care administration under division (D) 33132
of this section results from disallowance of federal financial 33133
participation by the United States department of health and human 33134
services, the provider shall not be required to repay the 33135
department of job and family serviceshealth care administration33136
until the federal disallowance becomes final.33137

       (G) Any fines paid under sections 5111.355164.50 to 5111.6233138
5164.78 of the Revised Code during any period for which the 33139
facility is required to repay the department of job and family 33140
serviceshealth care administration under division (D) of this 33141
section shall be offset against the amount the provider is 33142
required to repay the department for that period.33143

       (H) Prior to a change of ownership of a facility for which a 33144
provider has an obligation to repay the department of job and 33145
family serviceshealth care administration under division (D) of 33146
this section that has not become final, or has become final but 33147
not been paid, the department may do one or more of the following:33148

       (1) Require the provider to place money in escrow, or obtain 33149
a bond, in sufficient amount to indemnify the state against the 33150
provider's failure to repay the department after the change of 33151
ownership occurs;33152

       (2) Place a lien on the facility's real property;33153

       (3) Use any method to recover the payments that is available 33154
to the attorney general to recover payments on behalf of the 33155
department of job and family serviceshealth care administration.33156

       Sec. 5111.59.        Sec. 5164.75.  The department of job and family 33157
serviceshealth care administration, the department of health, and 33158
any contracting agency shall deliver a written notice, statement, 33159
or order to a nursing facility under sections 5111.355164.50 to 33160
5111.415164.56 and 5111.435164.59 to 5111.625164.78 of the 33161
Revised Code by certified mail or hand delivery. If the notice,33162
statement, or order is mailed, it shall be addressed to the33163
administrator of the facility as indicated in the department's or33164
agency's records. If it is hand delivered, it shall be delivered33165
to a person at the facility who would appear to the average33166
prudent person to have authority to accept it.33167

       Delivery of written notice by a nursing facility to the33168
department of health, the department of job and family services33169
health care administration, or a contracting agency under sections 33170
5111.355164.50 to 5111.625164.78 of the Revised Code shall be by 33171
certified mail or hand delivery to the appropriate department or 33172
the agency.33173

       Sec. 5111.60.        Sec. 5164.76.  (A) Except as provided in division (B) 33174
of this section, the following remedies are subject to appeal 33175
under Chapter 119. of the Revised Code:33176

       (1) An order issued under section 5111.455164.61, 5111.4633177
5164.62, 5111.515164.67, or 5111.585164.74 of the Revised Code 33178
terminating a nursing facility's participation in the medical 33179
assistancemedicaid program;33180

       (2) Appointment of a temporary manager of a facility under33181
division (A)(1)(b) or (2)(b) of section 5111.465164.62, or 33182
division (A)(1)(d) of section 5111.515164.67 of the Revised Code;33183

       (3) An order issued under section 5111.465164.62, 5111.4733184
5164.63, 5111.485164.64, 5111.515164.67, or 5111.575164.73 of 33185
the Revised Code denying payment to a facility under the medical 33186
assistancemedicaid program for all medicaid eligible residents 33187
admitted after the effective date of the order;33188

       (4) An order issued under section 5111.465164.62, 5111.4733189
5164.63, or 5111.485164.64 of the Revised Code denying payment to 33190
a facility under the medical assistancemedicaid program for 33191
medicaid eligible residents admitted after the effective date of 33192
the order who have certain diagnoses or special care needs 33193
specified by the department or agency;33194

       (5) A fine imposed under section 5111.465164.62, 5111.4733195
5164.63, or 5111.485164.64 of the Revised Code.33196

       (B) The department of job and family serviceshealth care 33197
administration or contracting agency may do any of the following 33198
prior to or during the pendency of any proceeding under Chapter 33199
119. of the Revised Code:33200

       (1) Issue and execute an order under section 5111.465164.62,33201
5111.515164.67, or 5111.585164.74 of the Revised Code 33202
terminating a nursing facility's participation in the medical 33203
assistancemedicaid program;33204

       (2) Appoint a temporary manager under division (A)(1)(b) or 33205
(2)(b) of section 5111.465164.62 or division (A)(1)(d) of section33206
5111.515164.67 of the Revised Code;33207

       (3) Issue and execute an order under section 5111.465164.62,33208
5111.475164.63, 5111.515164.67, or 5111.575164.73 of the 33209
Revised Code denying payment to a facility for all medicaid 33210
eligible residents admitted after the effective date of the order;33211

       (4) Issue and execute an order under section 5111.465164.6233212
or 5111.475164.63 or division (A), (B), or (C) of section 5111.4833213
5164.64 of the Revised Code denying payment to a facility for 33214
medicaid eligible residents admitted after the effective date of 33215
the order who have specified diagnoses or special care needs.33216

       (C) Whenever the department or agency imposes a remedy listed 33217
in division (B) of this section prior to or during the pendency of 33218
a proceeding, all of the following apply:33219

       (1) The provider against whom the action is taken shall have 33220
ten days after the date the facility actually receives the notice 33221
specified in section 119.07 of the Revised Code to request a 33222
hearing.33223

       (2) The hearing shall commence within thirty days after the 33224
date the department or agency receives the provider's request for 33225
a hearing.33226

       (3) The hearing shall continue uninterrupted from day to day, 33227
except for Saturdays, Sundays, and legal holidays, unless other 33228
interruptions are agreed to by the provider and the department or 33229
agency.33230

       (4) If the hearing is conducted by a hearing examiner, the33231
hearing examiner shall file a report and recommendations within 33232
ten days after the close of the hearing.33233

       (5) The provider shall have five days after the date the33234
hearing officer files the report and recommendations within which 33235
to file objections to the report and recommendations.33236

       (6) Not later than fifteen days after the date the hearing33237
officer files the report and recommendations, the director of job 33238
and family serviceshealth care administration or the director of 33239
the contracting agency shall issue an order approving, modifying, 33240
or disapproving the report and recommendations of the hearing 33241
examiner.33242

       (D) If the department or agency imposes more than one remedy 33243
as the result of deficiencies cited in a single survey, the 33244
proceedings for all of the remedies shall be consolidated. If any 33245
of the remedies are imposed during the pendency of a hearing, as 33246
permitted by division (B) of this section, the consolidated 33247
hearing shall be conducted in accordance with division (C) of this 33248
section. The consolidation of the remedies for purposes of a 33249
hearing does not affect the effective dates prescribed in sections 33250
5111.355164.50 to 5111.585164.74 of the Revised Code.33251

       (E) If a contracting agency conducts administrative33252
proceedings pertaining to remedies imposed under sections 5111.3533253
5164.50 to 5111.625164.78 of the Revised Code, the department of 33254
job and family serviceshealth care administration shall not be 33255
considered a party to the proceedings.33256

       Sec. 5111.61.        Sec. 5164.77.  (A)(1) Except as required by court 33257
order, as necessary for the administration or enforcement of any 33258
statute relating to nursing facilities, or as provided in division 33259
(C) of this section, the department of job and family services33260
health care administration and any contracting agency shall not 33261
release any of the following information without the permission of 33262
the individual or the individual's legal representative:33263

       (a) The identity of any resident of a nursing facility;33264

       (b) The identity of any individual who submits a complaint33265
about a nursing facility;33266

       (c) The identity of any individual who provides the33267
department or agency with information about a nursing facility and 33268
has requested confidentiality;33269

       (d) Any information that reasonably would tend to disclose33270
the identity of any individual described in division (A)(1)(a) to33271
(c) of this section.33272

       (2) An agency or individual to whom the department or33273
contracting agency is required, by court order or for the33274
administration or enforcement of a statute relating to nursing33275
facilities, to release information described in division (A)(1) of 33276
this section shall not release the information without the33277
permission of the individual who would be or would reasonably tend 33278
to be identified, or of the individual's legal representative, 33279
unless the agency or individual is required to release it by33280
division (C) of this section, by court order, or for the 33281
administration or enforcement of a statute relating to nursing 33282
facilities.33283

       (B) Except as provided in division (C) of this section, any 33284
record that identifies an individual described in division (A)(1) 33285
of this section or that reasonably would tend to identify such an 33286
individual is not a public record for the purposes of section 33287
149.43 of the Revised Code, and is not subject to inspection and 33288
copying under section 1347.08 of the Revised Code.33289

       (C) If the department or a contracting agency, or an agency 33290
or individual to whom the department or contracting agency was 33291
required by court order or for administration or enforcement of a 33292
statute relating to nursing facilities to release information 33293
described in division (A)(1) of this section, uses information in 33294
any administrative or judicial proceeding against a facility that 33295
reasonably would tend to identify an individual described in 33296
division (A)(1) of this section, the department, agency, or 33297
individual shall disclose that information to the facility. 33298
However, the department, agency, or individual shall not disclose 33299
information that directly identifies an individual described in 33300
divisions (A)(1)(a) to (c) of this section, unless the individual 33301
is to testify in the proceedings.33302

       (D) No person shall knowingly register a false complaint33303
about a nursing facility with the department or a contracting33304
agency, or knowingly swear or affirm the truth of a false33305
complaint, when the allegation is made for the purpose of33306
incriminating another.33307

       Sec. 5111.62.        Sec. 5164.78.  The proceeds of all fines, including33308
interest, collected under sections 5111.355164.50 to 5111.6233309
5164.78 of the Revised Code shall be deposited in the state 33310
treasury to the credit of the residents protection fund, which is 33311
hereby created. The proceeds of all fines, including interest, 33312
collected under section 173.42 of the Revised Code shall be 33313
deposited in the state treasury to the credit of the residents 33314
protection fund.33315

       Moneys in the fund shall be used for the protection of the33316
health or property of residents of nursing facilities in which the 33317
department of health finds deficiencies, including payment for the 33318
costs of relocation of residents to other facilities, maintenance 33319
of operation of a facility pending correction of deficiencies or 33320
closure, and reimbursement of residents for the loss of money 33321
managed by the facility under section 3721.15 of the Revised Code. 33322

       The fund shall be maintained and administered by the 33323
department of job and family serviceshealth care administration33324
under rules developed in consultation with the departments of 33325
health and aging and adopted by the director of job and family 33326
serviceshealth care administration under Chapter 119. of the 33327
Revised Code.33328

       Sec. 5111.63.        Sec. 5164.79. For the purposes of this section, 33329
"facility," "medicare," and "medicaid" havehas the same meanings33330
meaning as in section 3721.10 of the Revised Code.33331

       The department of health shall be the designee of the33332
department of job and family serviceshealth care administration33333
for the purpose of conducting a hearing pursuant to section 33334
3721.162 of the Revised Code concerning a facility's decision to 33335
transfer or discharge a resident if the resident is a medicaid 33336
recipient or medicare beneficiary.33337

       Sec. 5111.65.        Sec. 5164.82.  As used in sections 5111.655164.82 to 33338
5111.6885164.858 of the Revised Code:33339

       (A) "Change of operator" means an entering operator becoming 33340
the operator of a nursing facility or intermediate care facility 33341
for the mentally retarded in the place of the exiting operator.33342

       (1) Actions that constitute a change of operator include the 33343
following:33344

       (a) A change in an exiting operator's form of legal 33345
organization, including the formation of a partnership or 33346
corporation from a sole proprietorship;33347

       (b) A transfer of all the exiting operator's ownership 33348
interest in the operation of the facility to the entering 33349
operator, regardless of whether ownership of any or all of the 33350
real property or personal property associated with the facility is 33351
also transferred;33352

       (c) A lease of the facility to the entering operator or the 33353
exiting operator's termination of the exiting operator's lease;33354

       (d) If the exiting operator is a partnership, dissolution of 33355
the partnership;33356

       (e) If the exiting operator is a partnership, a change in 33357
composition of the partnership unless both of the following apply:33358

       (i) The change in composition does not cause the 33359
partnership's dissolution under state law.33360

       (ii) The partners agree that the change in composition does 33361
not constitute a change in operator.33362

       (f) If the operator is a corporation, dissolution of the 33363
corporation, a merger of the corporation into another corporation 33364
that is the survivor of the merger, or a consolidation of one or 33365
more other corporations to form a new corporation.33366

       (2) The following, alone, do not constitute a change of 33367
operator:33368

       (a) A contract for an entity to manage a nursing facility or 33369
intermediate care facility for the mentally retarded as the 33370
operator's agent, subject to the operator's approval of daily 33371
operating and management decisions;33372

       (b) A change of ownership, lease, or termination of a lease 33373
of real property or personal property associated with a nursing 33374
facility or intermediate care facility for the mentally retarded 33375
if an entering operator does not become the operator in place of 33376
an exiting operator;33377

       (c) If the operator is a corporation, a change of one or more 33378
members of the corporation's governing body or transfer of 33379
ownership of one or more shares of the corporation's stock, if the 33380
same corporation continues to be the operator.33381

       (B) "Effective date of a change of operator" means the day 33382
the entering operator becomes the operator of the nursing facility 33383
or intermediate care facility for the mentally retarded.33384

       (C) "Effective date of a facility closure" means the last day 33385
that the last of the residents of the nursing facility or 33386
intermediate care facility for the mentally retarded resides in 33387
the facility.33388

       (D) "Effective date of a voluntary termination" means the 33389
day the intermediate care facility for the mentally retarded 33390
ceases to accept medicaid patients.33391

       (E) "Effective date of a voluntary withdrawal of 33392
participation" means the day the nursing facility ceases to accept 33393
new medicaid patients other than the individuals who reside in the 33394
nursing facility on the day before the effective date of the 33395
voluntary withdrawal of participation.33396

       (F) "Entering operator" means the person or government entity 33397
that will become the operator of a nursing facility or 33398
intermediate care facility for the mentally retarded when a change 33399
of operator occurs.33400

       (G) "Exiting operator" means any of the following:33401

       (1) An operator that will cease to be the operator of a 33402
nursing facility or intermediate care facility for the mentally 33403
retarded on the effective date of a change of operator;33404

       (2) An operator that will cease to be the operator of a 33405
nursing facility or intermediate care facility for the mentally 33406
retarded on the effective date of a facility closure;33407

       (3) An operator of an intermediate care facility for the 33408
mentally retarded that is undergoing or has undergone a voluntary 33409
termination;33410

       (4) An operator of a nursing facility that is undergoing or 33411
has undergone a voluntary withdrawal of participation.33412

       (H)(1) "Facility closure" means discontinuance of the use of 33413
the building, or part of the building, that houses the facility as 33414
a nursing facility or intermediate care facility for the mentally 33415
retarded that results in the relocation of all of the facility's 33416
residents. A facility closure occurs regardless of any of the 33417
following:33418

       (a) The operator completely or partially replacing the 33419
facility by constructing a new facility or transferring the 33420
facility's license to another facility;33421

       (b) The facility's residents relocating to another of the 33422
operator's facilities;33423

       (c) Any action the department of health takes regarding the 33424
facility's certification under Title XIX of the "Social Security 33425
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended,for 33426
participation in the medicaid program that may result in the 33427
transfer of part of the facility's survey findings to another of 33428
the operator's facilities;33429

       (d) Any action the department of health takes regarding the 33430
facility's license under Chapter 3721. of the Revised Code;33431

       (e) Any action the department of mental retardation and 33432
developmental disabilities takes regarding the facility's license 33433
under section 5123.19 of the Revised Code.33434

       (2) A facility closure does not occur if all of the 33435
facility's residents are relocated due to an emergency evacuation 33436
and one or more of the residents return to a medicaid-certified 33437
bed in the facility not later than thirty days after the 33438
evacuation occurs.33439

       (I) "Fiscal year," "intermediate care facility for the 33440
mentally retarded," "nursing facility," "operator," "owner," and 33441
"provider agreement" have the same meanings as in section 5111.2033442
5164.01 of the Revised Code.33443

       (J) "Voluntary termination" means an operator's voluntary 33444
election to terminate the participation of an intermediate care 33445
facility for the mentally retarded in the medicaid program but to 33446
continue to provide service of the type provided by a residential 33447
facility as defined in section 5123.19 of the Revised Code.33448

       (K) "Voluntary withdrawal of participation" means an 33449
operator's voluntary election to terminate the participation of a 33450
nursing facility in the medicaid program but to continue to 33451
provide service of the type provided by a nursing facility.33452

       Sec. 5111.651.        Sec. 5164.821. Sections 5111.655164.82 to 5111.68833453
5164.858 of the Revised Code do not apply to a nursing facility or 33454
intermediate care facility for the mentally retarded that 33455
undergoes a facility closure, voluntary termination, voluntary 33456
withdrawal of participation, or change of operator on or before 33457
September 30, 2005, if the exiting operator provided written 33458
notice of the facility closure, voluntary termination, voluntary 33459
withdrawal of participation, or change of operator to the 33460
department of job and family services on or before June 30, 2005.33461

       Sec. 5111.66.        Sec. 5164.83. An exiting operator or owner of a 33462
nursing facility or intermediate care facility for the mentally 33463
retarded participating in the medicaid program shall provide the 33464
department of job and family serviceshealth care administration33465
written notice of a facility closure, voluntary termination, or 33466
voluntary withdrawal of participation not less than ninety days 33467
before the effective date of the facility closure, voluntary 33468
termination, or voluntary withdrawal of participation. The written 33469
notice shall include all of the following:33470

        (A) The name of the exiting operator and, if any, the exiting 33471
operator's authorized agent;33472

        (B) The name of the nursing facility or intermediate care 33473
facility for the mentally retarded that is the subject of the 33474
written notice;33475

        (C) The exiting operator's medicaid provider agreement number 33476
for the facility that is the subject of the written notice;33477

        (D) The effective date of the facility closure, voluntary 33478
termination, or voluntary withdrawal of participation;33479

        (E) The signature of the exiting operator's or owner's 33480
representative.33481

       Sec. 5111.67.        Sec. 5164.84. (A) An exiting operator or owner and 33482
entering operator shall provide the department of job and family 33483
serviceshealth care administration written notice of a change of 33484
operator if the nursing facility or intermediate care facility for 33485
the mentally retarded participates in the medicaid program and the 33486
entering operator seeks to continue the facility's participation. 33487
The written notice shall be provided to the department not later 33488
than forty-five days before the effective date of the change of 33489
operator if the change of operator does not entail the relocation 33490
of residents. The written notice shall be provided to the 33491
department not later than ninety days before the effective date of 33492
the change of operator if the change of operator entails the 33493
relocation of residents. The written notice shall include all of 33494
the following:33495

        (1) The name of the exiting operator and, if any, the exiting 33496
operator's authorized agent;33497

        (2) The name of the nursing facility or intermediate care 33498
facility for the mentally retarded that is the subject of the 33499
change of operator;33500

        (3) The exiting operator's medicaid provider agreement number 33501
for the facility that is the subject of the change of operator;33502

        (4) The name of the entering operator;33503

        (5) The effective date of the change of operator;33504

        (6) The manner in which the entering operator becomes the 33505
facility's operator, including through sale, lease, merger, or 33506
other action;33507

        (7) If the manner in which the entering operator becomes the 33508
facility's operator involves more than one step, a description of 33509
each step;33510

        (8) Written authorization from the exiting operator or owner 33511
and entering operator for the department to process a provider 33512
agreement for the entering operator;33513

        (9) The signature of the exiting operator's or owner's 33514
representative.33515

        (B) The entering operator shall include a completed 33516
application for a provider agreement with the written notice to 33517
the department. The entering operator shall attach to the 33518
application the following:33519

        (1) If the written notice is provided to the department 33520
before the date the exiting operator or owner and entering 33521
operator complete the transaction for the change of operator, all 33522
the proposed leases, management agreements, merger agreements and 33523
supporting documents, and sales contracts and supporting documents 33524
relating to the facility's change of operator;33525

        (2) If the written notice is provided to the department on or 33526
after the date the exiting operator or owner and entering operator 33527
complete the transaction for the change of operator, copies of all 33528
the executed leases, management agreements, merger agreements and 33529
supporting documents, and sales contracts and supporting documents 33530
relating to the facility's change of operator.33531

       Sec. 5111.671.        Sec. 5164.841. The department of job and family 33532
serviceshealth care administration may enter into a provider 33533
agreement with an entering operator that goes into effect at 12:01 33534
a.m. on the effective date of the change of operator if all of the 33535
following requirements are met:33536

       (A) The department receives a properly completed written 33537
notice required by section 5111.675164.84 of the Revised Code on 33538
or before the date required by that section.33539

        (B) The entering operator furnishes to the department copies 33540
of all the fully executed leases, management agreements, merger 33541
agreements and supporting documents, and sales contracts and 33542
supporting documents relating to the change of operator not later 33543
than ten days after the effective date of the change of operator.33544

        (C) The entering operator is eligible for medicaid payments 33545
as provided in section 5111.215164.02 of the Revised Code.33546

       Sec. 5111.672.        Sec. 5164.842. (A) The department of job and family 33547
serviceshealth care administration may enter into a provider 33548
agreement with an entering operator that goes into effect at 12:01 33549
a.m. on the date determined under division (B) of this section if 33550
all of the following are the case:33551

        (1) The department receives a properly completed written 33552
notice required by section 5111.675164.84 of the Revised Code.33553

        (2) The entering operator furnishes to the department copies 33554
of all the fully executed leases, management agreements, merger 33555
agreements and supporting documents, and sales contracts and 33556
supporting documents relating to the change of operator.33557

        (3) The requirement of division (A)(1) of this section is met 33558
after the time required by section 5111.675164.84 of the Revised 33559
Code, the requirement of division (A)(2) of this section is met 33560
more than ten days after the effective date of the change of 33561
operator, or both.33562

        (4) The entering operator is eligible for medicaid payments 33563
as provided in section 5111.215164.02 of the Revised Code.33564

        (B) The department shall determine the date a provider 33565
agreement entered into under this section is to go into effect as 33566
follows:33567

        (1) The effective date shall give the department sufficient 33568
time to process the change of operator, assure no duplicate 33569
payments are made, make the withholding required by section 33570
5111.6815164.851 of the Revised Code, and withhold the final 33571
payment to the exiting operator until one hundred eighty days 33572
after either of the following:33573

        (a) The date that the exiting operator submits to the 33574
department a properly completed cost report under section 5111.68233575
5164.852 of the Revised Code;33576

        (b) The date that the department waives the cost report 33577
requirement of section 5111.6825164.852 of the Revised Code.33578

        (2) The effective date shall be not earlier than the later of 33579
the effective date of the change of operator or the date that the 33580
exiting operator or owner and entering operator comply with 33581
section 5111.675164.84 of the Revised Code.33582

        (3) The effective date shall be not later than the following 33583
after the later of the dates specified in division (B)(2) of this 33584
section:33585

        (a) Forty-five days if the change of operator does not entail 33586
the relocation of residents;33587

        (b) Ninety days if the change of operator entails the 33588
relocation of residents.33589

       Sec. 5111.673.        Sec. 5164.843. A provider that enters into a 33590
provider agreement with the department of job and family services33591
health care administration under section 5111.6715164.841 or 33592
5111.6725164.842 of the Revised Code shall do all of the 33593
following:33594

        (A) Comply with all applicable federal statutes and 33595
regulations;33596

        (B) Comply with section 5111.225164.03 of the Revised Code 33597
and all other applicable state statutes and rules;33598

        (C) Comply with all the terms and conditions of the exiting 33599
operator's provider agreement, including, but not limited to, all 33600
of the following:33601

        (1) Any plan of correction;33602

        (2) Compliance with health and safety standards;33603

        (3) Compliance with the ownership and financial interest 33604
disclosure requirements of 42 C.F.R. 455.104, 455.105, and 1002.3;33605

        (4) Compliance with the civil rights requirements of 45 33606
C.F.R. parts 80, 84, and 90;33607

        (5) Compliance with additional requirements imposed by the 33608
department;33609

        (6) Any sanctions relating to remedies for violation of the 33610
provider agreement, including deficiencies, compliance periods, 33611
accountability periods, monetary penalties, notification for 33612
correction of contract violations, and history of deficiencies.33613

       Sec. 5111.674.        Sec. 5164.844. In the case of a change of operator, 33614
the exiting operator shall be considered to be the operator of the 33615
nursing facility or intermediate care facility for the mentally 33616
retarded for purposes of the medicaid program, including medicaid 33617
payments, until the effective date of the entering operator's 33618
provider agreement if the provider agreement is entered into under 33619
section 5111.6715164.841 or 5111.6725164.842 of the Revised 33620
Code.33621

       Sec. 5111.675.        Sec. 5164.845. The department of job and family 33622
serviceshealth care administration may enter into a provider 33623
agreement as provided in section 5111.225164.03 of the Revised 33624
Code, rather than section 5111.6715164.841 or 5111.6725164.84233625
of the Revised Code, with an entering operator if the entering 33626
operator does not agree to a provider agreement that satisfies the 33627
requirements of division (C) of section 5111.6735164.843 of the 33628
Revised Code. The department may not enter into the provider 33629
agreement unless the department of health certifies the nursing 33630
facility or intermediate care facility for the mentally retarded 33631
under Title XIX of the "Social Security Act," 79 Stat. 286 (1965), 33632
42 U.S.C. 1396, as amendedfor participation in the medicaid 33633
program. The effective date of the provider agreement shall not 33634
precede any of the following:33635

        (A) The date that the department of health certifies the 33636
facility;33637

        (B) The effective date of the change of operator;33638

        (C) The date the requirement of section 5111.675164.84 of 33639
the Revised Code is satisfied.33640

       Sec. 5111.676.        Sec. 5164.846. The director of job and family 33641
serviceshealth care administration may adopt rules in accordance 33642
with Chapter 119. of the Revised Code governing adjustments to the 33643
medicaid reimbursement rate for a nursing facility or intermediate 33644
care facility for the mentally retarded that undergoes a change of 33645
operator. No rate adjustment resulting from a change of operator 33646
shall be effective before the effective date of the entering 33647
operator's provider agreement. This is the case regardless of 33648
whether the provider agreement is entered into under section 33649
5111.6715164.841, section 5111.6725164.842, or, pursuant to 33650
section 5111.6755164.845, section 5111.225164.03 of the Revised 33651
Code.33652

       Sec. 5111.677.        Sec. 5164.847. Neither of the following shall affect 33653
the department of job and family services'health care 33654
administration's determination of whether or when a change of 33655
operator occurs or the effective date of an entering operator's 33656
provider agreement under section 5111.6715164.841, section 33657
5111.6725164.842, or, pursuant to section 5111.6755164.845, 33658
section 5111.225164.03 of the Revised Code:33659

        (A) The department of health's determination that a change of 33660
operator has or has not occurred for purposes of licensure under 33661
Chapter 3721. of the Revised Code;33662

        (B) The department of mental retardation and developmental 33663
disabilities' determination that a change of operator has or has 33664
not occurred for purposes of licensure under section 5123.19 of 33665
the Revised Code.33666

       Sec. 5111.68.        Sec. 5164.85. (A) On receipt of a written notice 33667
under section 5111.665164.83 of the Revised Code of a facility 33668
closure, voluntary termination, or voluntary withdrawal of 33669
participation or a written notice under section 5111.675164.84 of 33670
the Revised Code of a change of operator, the department of job 33671
and family serviceshealth care administration shall determine the 33672
amount of any overpayments made under the medicaid program to the 33673
exiting operator, including overpayments the exiting operator 33674
disputes, and other actual and potential debts the exiting 33675
operator owes or may owe to the department and United States 33676
centers for medicare and medicaid services under the medicaid 33677
program. In determining the exiting operator's other actual and 33678
potential debts to the department under the medicaid program, the 33679
department shall include all of the following that the department 33680
determines is applicable:33681

        (1) Refunds due the department under section 5111.275164.3833682
of the Revised Code;33683

        (2) Interest owed to the department and United States centers 33684
for medicare and medicaid services;33685

        (3) Final civil monetary and other penalties for which all 33686
right of appeal has been exhausted;33687

        (4) Money owed the department and United States centers for 33688
medicare and medicaid services from any outstanding final fiscal 33689
audit, including a final fiscal audit for the last fiscal year or 33690
portion thereof in which the exiting operator participated in the 33691
medicaid program.33692

        (B) If the department is unable to determine the amount of 33693
the overpayments and other debts for any period before the 33694
effective date of the entering operator's provider agreement or 33695
the effective date of the facility closure, voluntary termination, 33696
or voluntary withdrawal of participation, the department shall 33697
make a reasonable estimate of the overpayments and other debts for 33698
the period. The department shall make the estimate using 33699
information available to the department, including prior 33700
determinations of overpayments and other debts.33701

       Sec. 5111.681.        Sec. 5164.851. (A) Except as provided in division 33702
(B) of this section, the department of job and family services33703
health care administration shall withhold the greater of the 33704
following from payment due an exiting operator under the medicaid 33705
program:33706

        (1) The total amount of any overpayments made under the 33707
medicaid program to the exiting operator, including overpayments 33708
the exiting operator disputes, and other actual and potential 33709
debts, including any unpaid penalties, the exiting operator owes 33710
or may owe to the department and United States centers for 33711
medicare and medicaid services under the medicaid program;33712

        (2) An amount equal to the average amount of monthly payments 33713
to the exiting operator under the medicaid program for the 33714
twelve-month period immediately preceding the month that includes 33715
the last day the exiting operator's provider agreement is in 33716
effect or, in the case of a voluntary withdrawal of participation, 33717
the effective date of the voluntary withdrawal of participation.33718

       (B) The department may choose not to make the withholding 33719
under division (A) of this section if an entering operator does 33720
both of the following:33721

        (1) Enters into a nontransferable, unconditional, written 33722
agreement with the department to pay the department any debt the 33723
exiting operator owes the department under the medicaid program;33724

        (2) Provides the department a copy of the entering operator's 33725
balance sheet that assists the department in determining whether 33726
to make the withholding under division (A) of this section.33727

       Sec. 5111.682.        Sec. 5164.852. (A) Except as provided in division 33728
(B) of this section, an exiting operator shall file with the 33729
department of job and family serviceshealth care administration a 33730
cost report not later than ninety days after the last day the 33731
exiting operator's provider agreement is in effect or, in the case 33732
of a voluntary withdrawal of participation, the effective date of 33733
the voluntary withdrawal of participation. The cost report shall 33734
cover the period that begins with the day after the last day 33735
covered by the operator's most recent previous cost report 33736
required by section 5111.265164.37 of the Revised Code and ends 33737
on the last day the exiting operator's provider agreement is in 33738
effect or, in the case of a voluntary withdrawal of participation, 33739
the effective date of the voluntary withdrawal of participation. 33740
The cost report shall include, as applicable, all of the 33741
following:33742

        (1) The sale price of the nursing facility or intermediate 33743
care facility for the mentally retarded;33744

        (2) A final depreciation schedule that shows which assets are 33745
transferred to the buyer and which assets are not transferred to 33746
the buyer;33747

        (3) Any other information the department requires.33748

        (B) The department, at its sole discretion, may waive the 33749
requirement that an exiting operator file a cost report in 33750
accordance with division (A) of this section.33751

       Sec. 5111.683.        Sec. 5164.853. If an exiting operator required by 33752
section 5111.6825164.852 of the Revised Code to file a cost 33753
report with the department of job and family serviceshealth care 33754
administration fails to file the cost report in accordance with 33755
that section, all payments under the medicaid program for the 33756
period the cost report is required to cover are deemed 33757
overpayments until the date the department receives the properly 33758
completed cost report. The department may impose on the exiting 33759
operator a penalty of one hundred dollars for each calendar day 33760
the properly completed cost report is late.33761

       Sec. 5111.684.        Sec. 5164.854. The department of job and family 33762
serviceshealth care administration may not provide an exiting 33763
operator final payment under the medicaid program until the 33764
department receives all properly completed cost reports the 33765
exiting operator is required to file under sections 5111.2633766
5164.37 and 5111.6825164.852 of the Revised Code.33767

       Sec. 5111.685.        Sec. 5164.855. The department of job and family 33768
serviceshealth care administration shall determine the actual 33769
amount of debt an exiting operator owes the department under the 33770
medicaid program by completing all final fiscal audits not already 33771
completed and performing all other appropriate actions the 33772
department determines to be necessary. The department shall issue 33773
a debt summary report on this matter not later than ninety days 33774
after the date the exiting operator files the properly completed 33775
cost report required by section 5111.6825164.852 of the Revised 33776
Code with the department or, if the department waives the cost 33777
report requirement for the exiting operator, ninety days after the 33778
date the department waives the cost report requirement. The report 33779
shall include the department's findings and the amount of debt the 33780
department determines the exiting operator owes the department and 33781
United States centers for medicare and medicaid services under the 33782
medicaid program. Only the parts of the report that are subject to 33783
an adjudication as specified in section 5111.305164.032 of the 33784
Revised Code are subject to an adjudication conducted in 33785
accordance with Chapter 119. of the Revised Code.33786

       Sec. 5111.686.        Sec. 5164.856. The department of job and family 33787
serviceshealth care administration shall release the actual 33788
amount withheld under division (A) of section 5111.6815164.851 of 33789
the Revised Code, less any amount the exiting operator owes the 33790
department and United States centers for medicare and medicaid 33791
services under the medicaid program, as follows:33792

        (A) Ninety-one days after the date the exiting operator files 33793
a properly completed cost report required by section 5111.68233794
5164.852 of the Revised Code unless the department issues the 33795
report required by section 5111.6855164.855 of the Revised Code 33796
not later than ninety days after the date the exiting operator 33797
files the properly completed cost report;33798

        (B) Not later than thirty days after the exiting operator 33799
agrees to a final fiscal audit resulting from the report required 33800
by section 5111.6855164.855 of the Revised Code if the department 33801
issues the report not later than ninety days after the date the 33802
exiting operator files a properly completed cost report required 33803
by section 5111.6825164.852 of the Revised Code;33804

        (C) Ninety-one days after the date the department waives the 33805
cost report requirement of section 5111.6825164.852 of the 33806
Revised Code unless the department issues the report required by 33807
section 5111.6855164.855 of the Revised Code not later than 33808
ninety days after the date the department waives the cost report 33809
requirement;33810

        (D) Not later than thirty days after the exiting operator 33811
agrees to a final fiscal audit resulting from the report required 33812
by section 5111.6855164.855 of the Revised Code if the department 33813
issues the report not later than ninety days after the date the 33814
department waives the cost report requirement of section 5111.68233815
5164.852 of the Revised Code.33816

       Sec. 5111.687.        Sec. 5164.857. The department of job and family 33817
serviceshealth care administration, at its sole discretion, may 33818
release the amount withheld under division (A) of section 5111.68133819
5164.851 of the Revised Code if the exiting operator submits to 33820
the department written notice of a postponement of a change of 33821
operator, facility closure, voluntary termination, or voluntary 33822
withdrawal of participation and the transactions leading to the 33823
change of operator, facility closure, voluntary termination, or 33824
voluntary withdrawal of participation are postponed for at least 33825
thirty days but less than ninety days after the date originally 33826
proposed for the change of operator, facility closure, voluntary 33827
termination, or voluntary withdrawal of participation as reported 33828
in the written notice required by section 5111.665164.83 or 33829
5111.675164.84 of the Revised Code. The department shall release 33830
the amount withheld if the exiting operator submits to the 33831
department written notice of a cancellation or postponement of a 33832
change of operator, facility closure, voluntary termination, or 33833
voluntary withdrawal of participation and the transactions leading 33834
to the change of operator, facility closure, voluntary 33835
termination, or voluntary withdrawal of participation are canceled 33836
or postponed for more than ninety days after the date originally 33837
proposed for the change of operator, facility closure, voluntary 33838
termination, or voluntary withdrawal of participation as reported 33839
in the written notice required by section 5111.665164.83 or 33840
5111.675164.84 of the Revised Code.33841

        After the department receives a written notice regarding a 33842
cancellation or postponement of a facility closure, voluntary 33843
termination, or voluntary withdrawal of participation, the exiting 33844
operator or owner shall provide new written notice to the 33845
department under section 5111.665164.83 of the Revised Code 33846
regarding any transactions leading to a facility closure, 33847
voluntary termination, or voluntary withdrawal of participation at 33848
a future time. After the department receives a written notice 33849
regarding a cancellation or postponement of a change of operator, 33850
the exiting operator or owner and entering operator shall provide 33851
new written notice to the department under section 5111.675164.8433852
of the Revised Code regarding any transactions leading to a change 33853
of operator at a future time.33854

       Sec. 5111.688.        Sec. 5164.858. The director of job and family 33855
serviceshealth care administration may adopt rules under section 33856
5111.025163.15 of the Revised Code to implement sections 5111.6533857
5164.82 to 5111.6885164.858 of the Revised Code, including rules 33858
applicable to an exiting operator that provides written 33859
notification under section 5111.665164.83 of the Revised Code of 33860
a voluntary withdrawal of participation. Rules adopted under this 33861
section shall comply with section 1919(c)(2)(F) of the "Social 33862
Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396r(c)(2)(F), 33863
regarding restrictions on transfers or discharges of nursing 33864
facility residents in the case of a voluntary withdrawal of 33865
participation. The rules may prescribe a medicaid reimbursement 33866
methodology and other procedures that are applicable after the 33867
effective date of a voluntary withdrawal of participation that 33868
differ from the reimbursement methodology and other procedures 33869
that would otherwise apply.33870

       Sec. 5111.99.        Sec. 5164.99.  (A) Whoever violates division (B) of 33871
section 5111.265164.37 or division (E) of section 5111.3133872
5164.033 of the Revised Code shall be fined not less than five 33873
hundred dollars nor more than one thousand dollars for the first33874
offense and not less than one thousand dollars nor more than five33875
thousand dollars for each subsequent offense. Fines paid under 33876
this section shall be deposited in the state treasury to the 33877
credit of the general revenue fund.33878

       (B) Whoever violates division (D) of section 5111.615164.7733879
of the Revised Code is guilty of registering a false complaint, a 33880
misdemeanor of the first degree.33881

       Sec. 5165.01.  As used in this chapter:33882

       "Care management system" means the medicaid managed care 33883
program established under section 5165.02 of the Revised Code.33884

       "Emergency services" has the same meaning as in 42 U.S.C. 33885
1396u-2(b)(2).33886

       "Medicaid managed care organization" means a managed care 33887
organization that has entered into a contract with the department 33888
of health care administration under section 5165.05 of the Revised 33889
Code.33890

       "Provider" has the same meaning as in section 5163.01 of the 33891
Revised Code.33892

       Sec. 5165.02. The department of health care administration 33893
shall establish a care management system as part of the medicaid 33894
program. The department shall submit, if necessary, applications 33895
to the United States department of health and human services for 33896
waivers of federal medicaid requirements that would otherwise be 33897
violated in the implementation of the system.33898

       Sec. 5111.16.        Sec. 5165.03. (A) As part of the medicaid program, 33899
the department of job and family services shall establish a care 33900
management system. The department shall submit, if necessary, 33901
applications to the United States department of health and human 33902
services for waivers of federal medicaid requirements that would 33903
otherwise be violated in the implementation of the system.33904

       (B) The department of health care administration shall 33905
implement the care management system in some or all counties and 33906
shall designate the medicaid recipients who are required or 33907
permitted to participate in the system. In the department's 33908
implementation of the system and designation of participants, all 33909
of the following apply:33910

       (1)(A) In the case of individuals who receive medicaid on the 33911
basis of being included in the category identified by the 33912
department as covered families and children, the department shall 33913
implement the care management system in all counties. All 33914
individuals included in the category shall be designated for 33915
participation, except for indivdualsindividuals included in one 33916
or more of the medicaid recipient groups specified in 42 C.F.R. 33917
438.50(d). The department shall designate the participants not 33918
later than January 1, 2006. Beginning not later than December 31, 33919
2006, the department shall ensure that all participants are 33920
enrolled in health insuring corporations under contract with the 33921
department pursuant to section 5111.175165.05 of the Revised 33922
Code.33923

       (2)(B) In the case of individuals who receive medicaid on the 33924
basis of being aged, blind, or disabled, as specified in division 33925
(A)(2)(B) of section 5111.015162.01 of the Revised Code, the 33926
department shall implement the care management system in all 33927
counties. All individuals included in the category shall be 33928
designated for participation, except for the individuals specified 33929
in divisions (B)(2)(a) to (e) of this section. Beginning not later 33930
than December 31, 2006, the department shall ensure that all 33931
participants are enrolled in health insuring corporations under 33932
contract with the department pursuant to section 5111.175165.0533933
of the Revised Code.33934

        In designating participants who receive medicaid on the basis 33935
of being aged, blind, or disabled, the department shall not 33936
include any of the following:33937

       (a)(1) Individuals who are under twenty-one years of age;33938

       (b)(2) Individuals who are institutionalized;33939

       (c)(3) Individuals who become eligible for medicaid by 33940
spending down their income or resources to a level that meets the 33941
medicaid program's financial eligibility requirements;33942

       (d)(4) Individuals who are dually eligible under the medicaid 33943
program and the medicare program established under Title XVIII of 33944
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as 33945
amended;33946

       (e)(5) Individuals to the extent that they are receiving 33947
medicaid services through a medicaid waiver component, as defined 33948
in section 5111.855163.50 of the Revised Code.33949

       (3)(C) Alcohol, drug addiction, and mental health services 33950
covered by medicaid shall not be included in any component of the 33951
care management system when the nonfederal share of the cost of 33952
those services is provided by a board of alcohol, drug adiction33953
addiction, and mental health services or a state agency other than 33954
the department of job and family serviceshealth care 33955
administration, but the recipients of those services may otherwise 33956
be designated for participation in the system.33957

       (C) Subject to division (B) of this section, the department 33958
may do both of the following under the care management system:33959

       (1) Require or permit participants in the system to obtain 33960
health care services from providers designated by the department;33961

       (2) Require or permit participants in the system to obtain 33962
health care services through managed care organizations under 33963
contract with the department pursuant to section 5111.17 of the 33964
Revised Code.33965

       (D)(1) The department shall prepare an annual report on the 33966
care management system. The report shall address the department's 33967
ability to implement the system, including all of the following 33968
components:33969

       (a) The required designation of participants included in the 33970
category identified by the department as covered families and 33971
children;33972

       (b) The required designation of participants included in the 33973
aged, blind, or disabled category of medicaid recipients;33974

       (c) The conduct of the pilot program for chronically ill 33975
children established under section 5111.163 of the Revised Code;33976

       (d) The use of any programs for enhanced care management.33977

       (2) The department shall submit each annual report to the 33978
general assembly. The first report shall be submitted not later 33979
than October 1, 2007.33980

       (E) The director of job and family services may adopt rules 33981
in accordance with Chapter 119. of the Revised Code to implement 33982
this section.33983

       Sec. 5165.04.  Subject to section 5165.03 of the Revised 33984
Code, the department of health care administration may do both of 33985
the following under the care management system:33986

       (A) Require or permit participants in the system to obtain 33987
health care services from providers designated by the department;33988

       (B) Require or permit participants in the system to obtain 33989
health care services through managed care organizations under 33990
contract with the department pursuant to section 5165.05 of the 33991
Revised Code.33992

       Sec. 5111.17.        Sec. 5165.05. (A) The department of job and family 33993
serviceshealth care administration may enter into contracts with 33994
managed care organizations, including health insuring 33995
corporations, under which the organizations are authorized to33996
provide, or arrange for the provision of, health care services to33997
medical assistancemedicaid recipients who are required or 33998
permitted to obtain health care services through managed care33999
organizations as part of the care management system established 34000
under section 5111.16 of the Revised Code.34001

       (B) The director of job and family services may adopt rules34002
in accordance with Chapter 119. of the Revised Code to implement34003
this section.34004

       (C) The department of job and family serviceshealth care 34005
administration shall allow managed care plans to use providers 34006
to render care upon completion of the managed care plan's 34007
credentialing process.34008

       Sec. 5165.06. The department of health care administration 34009
shall develop and implement a financial incentive program to 34010
improve and reward positive health outcomes through the managed 34011
care organization contracts entered into under section 5165.05 of 34012
the Revised Code. In developing and implementing the program, the 34013
department may take into consideration the recommendations 34014
regarding the program made by the medicaid care management working 34015
group created under section 5165.19 of the Revised Code.34016

       Sec. 5111.171.        Sec. 5165.07. (A) The department of job and family 34017
serviceshealth care administration may provide financial 34018
incentive awards to medicaid managed care organizations under 34019
contract with the department pursuant to section 5111.17 of the 34020
Revised Code that meet or exceed performance standards specified 34021
in provider agreements or rules adopted by the departmentunder 34022
section 5165.18 of the Revised Code. The department may specify in 34023
a contract with a managed care organization the amounts of 34024
financial incentive awards, methodology for distributing awards, 34025
types of awards, and standards for administration by the 34026
department.34027

       (B) There is hereby created in the state treasury the health34028
care compliance fund. The fund shall consist of all fines imposed34029
on and collected from managed care organizations for failure to 34030
meet performance standards or other requirements specified in34031
provider agreements or rules adopted by the department. All34032
investment earnings of the fund shall be credited to the fund.34033
Moneys credited to the fund shall be used solely for the following34034
purposes:34035

       (1) To reimburse managed care organizations that have paid34036
fines for failures to meet performance standards or other34037
requirements and that have come into compliance by meeting34038
requirements as specified by the department;34039

       (2) To provide financial incentive awards established34040
pursuant to division (A) of this section and specified in34041
contracts between managed care organizations and the department.34042

       Sec. 5165.08.  There is hereby created in the state treasury 34043
the health care compliance fund. The fund shall consist of all 34044
fines imposed on and collected from medicaid managed care 34045
organizations for failure to meet performance standards or other 34046
requirements specified in provider agreements or rules under 34047
section 5165.18 of the Revised Code. All investment earnings of 34048
the fund shall be credited to the fund. Moneys credited to the 34049
fund shall be used solely for the following purposes:34050

       (A) To reimburse medicaid managed care organizations that 34051
have paid fines for failures to meet performance standards or 34052
other requirements and that have come into compliance by meeting 34053
requirements as specified by the department;34054

       (B) To provide financial incentive awards established 34055
pursuant to section 5165.06 of the Revised Code and specified in 34056
contracts between medicaid managed care organizations and the 34057
department.34058

       Sec. 5111.172.        Sec. 5165.09.  (A) When contracting under section 34059
5111.175165.05 of the Revised Code with a managed care 34060
organization that is a health insuring corporation, the 34061
department of job and family serviceshealth care administration34062
may require the health insuring corporation to provide coverage of 34063
prescription drugs for medicaid recipients enrolled in the health 34064
insuring corporation. In providing the required coverage, the 34065
health insuring corporation may, subject to the department's 34066
approval, use strategies for the management of drug utilization.34067

       (B) As used in this division, "controlled substance" has the 34068
same meaning as in section 3719.01 of the Revised Code.34069

       If a health insuring corporation is required under this 34070
section to provide coverage of prescription drugs, the department 34071
shall permit the health insuring corporation to develop and 34072
implement a pharmacy utilization management program under which 34073
prior authorization through the program is established as a 34074
condition of obtaining a controlled substance pursuant to a 34075
prescription. The program may include processes for requiring 34076
medicaid recipients at high risk for fraud or abuse involving 34077
controlled substances to have their prescriptions for controlled 34078
substances filled by a pharmacy, medical provider, or health care 34079
facility designated by the program.34080

       Sec. 5111.173.        Sec. 5165.10.  The department of job and family 34081
serviceshealth care administration shall appoint a temporary 34082
manager for a medicaid managed care organization under contract 34083
with the department pursuant to section 5111.17 of the Revised 34084
Code if the department determines that the medicaid managed care 34085
organization has repeatedly failed to meet substantive 34086
requirements specified in section 1903(m) of the "Social Security 34087
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396b(m), as amended; section 34088
1932 of the Social Security Act, 42 U.S.C. 1396u-2, as amended; or 34089
42 C.F.R. 438 Part I. The appointment of a temporary manager does 34090
not preclude the department from imposing other sanctions 34091
available to the department against the medicaid managed care 34092
organization.34093

       The medicaid managed care organization shall pay all costs of 34094
having the temporary manager perform the temporary manager's 34095
duties, including all costs the temporary manager incurs in 34096
performing those duties. If the temporary manager incurs costs or 34097
liabilities on behalf of the medicaid managed care organization, 34098
the medicaid managed care organization shall pay those costs and 34099
be responsible for those liabilities. 34100

       The appointment of a temporary manager is not subject to 34101
Chapter 119. of the Revised Code, but the medicaid managed care 34102
organization may request a reconsideration of the appointment. 34103
Reconsiderations shall be requested and conducted in accordance 34104
with rules the director of job and family services shall adopt in 34105
accordance with Chapter 119.adopted under section 5165.18 of the 34106
Revised Code.34107

       The appointment of a temporary manager does not cause the 34108
medicaid managed care organization to lose the right to appeal, in 34109
accordance with Chapter 119. of the Revised Code, any proposed 34110
termination or any decision not to renew the medicaid managed care 34111
organization's medicaid provider agreement or the right to 34112
initiate the sale of the medicaid managed care organization or its 34113
assets.34114

       In addition to the rules required to be adopted under this 34115
section, the director may adopt any other rules necessary to 34116
implement this section. The rules shall be adopted in accordance 34117
with Chapter 119. of the Revised Code.34118

       Sec. 5111.177.        Sec. 5165.11.  When contracting under section 34119
5111.175165.05 of the Revised Code with a health insuring 34120
corporation that holds a certificate of authority under Chapter 34121
1751. of the Revised Code, the department of job and family 34122
serviceshealth care administration shall require the health 34123
insuring corporation to provide a grievance process for medicaid 34124
recipients in accordance with 42 C.F.R. 438, subpart F.34125

       Sec. 5111.174.        Sec. 5165.12.  The department of job and family 34126
serviceshealth care administration may disenroll some or all 34127
medicaid recipients enrolled in a medicaid managed care 34128
organization under contract with the department pursuant to 34129
section 5111.17 of the Revised Code if the department proposes to 34130
terminate or not to renew the contract and determines that the 34131
recipients' access to medically necessary services is jeopardized 34132
by the proposal to terminate or not to renew the contract. The 34133
disenrollment is not subject to Chapter 119. of the Revised Code, 34134
but the medicaid managed care organization may request a 34135
reconsideration of the disenrollment. Reconsiderations shall be 34136
requested and conducted in accordance with rules the director of 34137
job and family services shall adopt in accordance with Chapter 34138
119.adopted under section 5165.18 of the Revised Code. The 34139
request for, or conduct of, a reconsideration regarding a proposed 34140
disenrollment shall not delay the disenrollment.34141

       In addition to the rules required to be adopted under this 34142
section, the director may adopt any other rules necessary to 34143
implement this section. The rules shall be adopted in accordance 34144
with Chapter 119. of the Revised Code.34145

       Sec. 5111.175.        Sec. 5165.13. For the purpose of determining the 34146
amount the department of job and family serviceshealth care 34147
administration pays hospitals under section 5112.085166.07 of the 34148
Revised Code and the amount of disproportionate share hospital 34149
payments paid by the medicare program established under Title 34150
XVIII of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 34151
1396n, as amended, a medicaid managed care organization under 34152
contract with the department pursuant to section 5111.17 of the 34153
Revised Code authorizing the organizationauthorized to provide, 34154
or arrange for the provision of, hospital services to medicaid 34155
recipients shall keep detailed records for each hospital with34156
which it contracts about the cost to the hospital of providing the34157
services, payments made by the organization to the hospital for 34158
the services, utilization of hospital services by medicaid34159
recipients enrolled in the organization, and other utilization34160
data required by the department.34161

       Sec. 5111.162.        Sec. 5165.14.  (A) As used in this section:34162

       (1) "Emergency services" has the same meaning as in section 34163
1932(b)(2) of the "Social Security Act," 79 Stat. 286 (1965), 42 34164
U.S.C. 1396u-2(b)(2), as amended.34165

       (2) "Medicaid managed care organization" means a managed care 34166
organization that has entered into a contract with the department 34167
of job and family services pursuant to section 5111.17 of the 34168
Revised Code.34169

       (B) Except as provided in division (C)(B) of this section, 34170
when a participant in the care management system established under 34171
section 5111.16 of the Revised Code is enrolled in a medicaid 34172
managed care organization and the organization refers the 34173
participant to receive services, other than emergency services 34174
provided on or after January 1, 2007, at a hospital that 34175
participates in the medicaid program but is not under contract 34176
with the organization, the hospital shall provide the service for 34177
which the referral was made and shall accept from the 34178
organization, as payment in full, the amount derived from the 34179
reimbursement rate used by the department to reimburse other 34180
hospitals of the same type for providing the same service to a 34181
medicaid recipient who is not enrolled in a medicaid managed care 34182
organization.34183

       (C)(B) A hospital is not subject to division (B)(A) of this 34184
section if all of the following are the case:34185

        (1) The hospital is located in a county in which participants 34186
in the care management system are required before January 1, 2006, 34187
to be enrolled in a medicaid managed care organization that is a 34188
health insuring corporation;34189

        (2) The hospital has entered into a contract before January 34190
1, 2006, with at least one health insuring corporation serving the 34191
participants specified in division (C)(B)(1) of this section;34192

        (3) The hospital remains under contract with at least one 34193
health insuring corporation serving participants in the care 34194
management system who are required to be enrolled in a health 34195
insuring corporation.34196

       (D) The director of job and family services shall adopt rules 34197
specifying the circumstances under which a medicaid managed care 34198
organization is permitted to refer a participant in the care 34199
management system to a hospital that is not under contract with 34200
the organization. The director may adopt any other rules necessary 34201
to implement this section. All rules adopted under this section 34202
shall be adopted in accordance with Chapter 119. of the Revised 34203
Code.34204

       Sec. 5111.163.        Sec. 5165.15. (A) As used in this section:34205

       (1) "Emergency services" has the same meaning as in section 34206
1932(b)(2) of the "Social Security Act," 79 Stat. 286 (1965), 42 34207
U.S.C. 1396u-2(b)(2), as amended.34208

       (2) "Medicaid managed care organization" has the same meaning 34209
as in section 5111.162 of the Revised Code.34210

       (3) "Provider" means any person, institution, or entity that 34211
furnishes emergency services to a medicaid recipient enrolled in a 34212
medicaid managed care organization, regardless of whether the 34213
person, institution, or entity has a provider agreement with the 34214
department of job and family services pursuant to Title XIX of the 34215
"Social Security Act." 34216

       (B) When a participant in the care management system 34217
established under section 5111.16 of the Revised Code is enrolled 34218
in a medicaid managed care organization and receives emergency 34219
services on or after January 1, 2007, from a provider that is not 34220
under contract with the organization, the provider shall accept 34221
from the organization, as payment in full, not more than the 34222
amounts (less any payments for indirect costs of medical education 34223
and direct costs of graduate medical education) that the provider 34224
could collect if the participant received medicaid other than 34225
through enrollment in a managed care organization.34226

       Sec. 5111.178.        Sec. 5165.16. (A) The director of job and family 34227
serviceshealth care administration shall determine whether a 34228
waiver of federal medicaid requirements is necessary to fulfill 34229
the requirements of section 3901.3814 of the Revised Code. If the 34230
director determines a waiver is necessary, the department of job 34231
and family serviceshealth care administration shall apply to the 34232
United States secretary of health and human services for the 34233
waiver.34234

       (B)(1) If the director determines that section 3901.3814 of 34235
the Revised Code can be implemented without a waiver or a waiver 34236
is granted, the department shall notify the department of 34237
insurance that the section can be implemented. Implementation of 34238
the section shall be effective eighteen months after the notice is 34239
sent.34240

        (2) At the time the notice is given under division (B)(1) of 34241
this section, the department shall also give notice to each health 34242
insuring corporation that provides coverage to medicaid 34243
recipients. The notice shall inform the corporation that sections 34244
3901.38 and 3901.381 to 3901.3814 of the Revised Code apply to 34245
claims for services rendered to recipients on the date determined 34246
under division (B)(1) of this section, instead of the prompt 34247
payment requirements of 42 C.F.R. 447.46. That date shall be 34248
specified in the notice.34249

       Sec. 5165.17.  (A) The department of health care 34250
administration shall prepare an annual report on the care 34251
management system. The report shall address the department's 34252
ability to implement the system, including all of the following 34253
components:34254

       (1) The required designation of participants included in the 34255
category identified by the department as covered families and 34256
children;34257

       (2) The required designation of participants included in the 34258
aged, blind, or disabled category of medicaid recipients;34259

       (3) The use of any programs for enhanced care management.34260

       (B) The department shall submit each annual report to the 34261
general assembly. The first report shall be submitted not later 34262
than October 1, 2007.34263

       Sec. 5165.18.  The director of health care administration 34264
shall adopt rules in accordance with Chapter 119. of the Revised 34265
Code to implement care management system, including rules that do 34266
all of the following:34267

       (A) Specify the circumstances under which a medicaid managed 34268
care organization is permitted to refer a participant in the care 34269
management system to a hospital that is not under contract with 34270
the organization;34271

       (B) Specify performance standards for medicaid managed care 34272
organizations;34273

       (C) The method by which a medicaid managed care organization 34274
may request a reconsideration of the appointment of a temporary 34275
manager under section 5165.10 of the Revised Code and the method 34276
by which the reconsideration is to be conducted;34277

       (D) The method by which a medicaid managed care organization 34278
may request a reconsideration of a disenrollment under section 34279
5165.12 of the Revised Code and the method by which the 34280
reconsideration is to be conducted.34281

       Sec. 5111.13.        Sec. 5165.30.  (A) As used in this section,34282
"cost-effective" and "group health plan" have the same meanings as 34283
in section 1906 of the "Social Security Act," 49 Stat. 620 (1935),34284
42 U.S.C.A. 1396e, as amended, and any regulations adopted under 34285
that section.34286

       (B) The department of job and family serviceshealth care 34287
administration, pursuant to guidelines issued by the United States 34288
secretary of health and human services, shall identify cases in 34289
which enrollment of an individual otherwise eligible for medical 34290
assistance under this chapterthe medicaid program in a group 34291
health plan in which the individual is eligible to enroll and 34292
payment of the individual's premiums, deductibles, coinsurance, 34293
and other cost-sharing expenses is cost effective.34294

       The department shall require, as a condition of eligibility34295
for medical assistancethe medicaid program, individuals 34296
identified under this division, or in the case of a child, the 34297
child's parent, to apply for enrollment in the group health plan, 34298
except that the failure of a parent to enroll self or the parent's 34299
child in a group health plan does not affect the child's34300
eligibility under the medical assistancemedicaid program.34301

       The department shall pay enrollee premiums and deductibles,34302
coinsurance, and other cost-sharing obligations for services and34303
items otherwise covered under the medical assistancemedicaid34304
program. The department shall treat coverage under the group 34305
health plan in the same manner as any other third-party liability 34306
under the program. If not all members of a family are eligible for 34307
medical assistancethe medicaid program and enrollment of the 34308
eligible members in a group health plan is not possible without 34309
also enrolling the members who are ineligible for medical 34310
assistancethe medicaid program, the department shall pay the 34311
premiums for the ineligible members if the payments are cost 34312
effective. The department shall not pay deductibles, coinsurance, 34313
or other cost-sharing obligations of enrolled members who are not 34314
eligible for medical assistancethe medicaid program.34315

       The department may make payments under this section to34316
employers, insurers, or other entities. The department may make34317
the payments without entering into a contract with employers,34318
insurers, or other entities.34319

       (C) To the extent permitted by federal law and regulations, 34320
the department of job and family serviceshealth care 34321
administration shall coordinate the medical assistancemedicaid34322
program with group health plans in such a manner that the medical 34323
assistancemedicaid program serves as a supplement to the group 34324
health plans. In its coordination efforts, the department shall 34325
consider cost-effectiveness and quality of care. The department 34326
may enter into agreements with group health plans as necessary to 34327
implement this division.34328

       (D) The director of job and family serviceshealth care 34329
administration shall adopt rules in accordance with Chapter 119. 34330
of the Revised Code to implement this section.34331

       Sec. 5112.01.        Sec. 5166.01.  As used in sections 5112.035166.02 to 34332
5112.215166.14 of the Revised Code:34333

       (A)(1) "Hospital" means a nonfederal hospital to which either34334
of the following applies:34335

       (a) The hospital is registered under section 3701.07 of the34336
Revised Code as a general medical and surgical hospital or a34337
pediatric general hospital, and provides inpatient hospital34338
services, as defined in 42 C.F.R. 440.10;34339

       (b) The hospital is recognized under the medicare program34340
established by Title XVIII of the "Social Security Act," 49 Stat.34341
620 (1935), 42 U.S.C.A. 301, as amended, as a cancer hospital and34342
is exempt from the medicare prospective payment system.34343

       "Hospital" does not include a hospital operated by a health34344
insuring corporation that has been issued a certificate of34345
authority under section 1751.05 of the Revised Code or a hospital34346
that does not charge patients for services.34347

       (2) "Disproportionate share hospital" means a hospital that34348
meets the definition of a disproportionate share hospital in rules34349
adopted under section 5112.035166.02 of the Revised Code.34350

       (B) "Bad debt," "charity care," "courtesy care," and34351
"contractual allowances" have the same meanings given these terms34352
in regulations adopted under Title XVIII of the "Social Security34353
Actgoverning the medicare program."34354

       (C) "Cost reporting period" means the twelve-month period34355
used by a hospital in reporting costs for purposes of Title XVIII34356
of the "Social Security Actthe medicare program."34357

       (D) "Governmental hospital" means a county hospital with more34358
than five hundred registered beds or a state-owned and -operated34359
hospital with more than five hundred registered beds.34360

       (E) "Indigent care pool" means the sum of the following:34361

       (1) The total of assessments to be paid in a program year by34362
all hospitals under section 5112.065166.05 of the Revised Code, 34363
less the assessments deposited into the legislative budget 34364
services fund under section 5112.195166.13 of the Revised Code34365
and into the health care services administration fund created 34366
under section 5111.945161.15 of the Revised Code;34367

       (2) The total amount of intergovernmental transfers required34368
to be made in the same program year by governmental hospitals34369
under section 5112.075166.06 of the Revised Code, less the amount 34370
of transfers deposited into the legislative budget services fund34371
under section 5112.195166.13 of the Revised Code and into the 34372
health care services administration fund created under section 34373
5111.945161.15 of the Revised Code;34374

       (3) The total amount of federal matching funds that will be34375
made available in the same program year as a result of funds34376
distributed by the department of job and family serviceshealth 34377
care administration to hospitals under section 5112.085166.07 of 34378
the Revised Code.34379

       (F) "Intergovernmental transfer" means any transfer of money34380
by a governmental hospital under section 5112.075166.06 of the 34381
Revised Code.34382

       (G) "Medical assistance program" means the program of medical34383
assistance established under section 5111.01 of the Revised Code34384
and Title XIX of the "Social Security Act."34385

       (H) "Program year" means a period beginning the first day of34386
October, or a later date designated in rules adopted under section34387
5112.035166.02 of the Revised Code, and ending the thirtieth day 34388
of September, or an earlier date designated in rules adopted under34389
that section.34390

       (I)(H) "Registered beds" means the total number of hospital34391
beds registered with the department of health, as reported in the34392
most recent "directory of registered hospitals" published by the34393
department of health.34394

       (J)(I) "Total facility costs" means the total costs for all34395
services rendered to all patients, including the direct, indirect,34396
and overhead cost to the hospital of all services, supplies,34397
equipment, and capital related to the care of patients, regardless34398
of whether patients are enrolled in a health insuring corporation,34399
excluding costs associated with providing skilled nursing services34400
in distinct-part nursing facility units, as shown on the34401
hospital's cost report filed under section 5112.045166.03 of the 34402
Revised Code. Effective October 1, 1993, if rules adopted under 34403
section 5112.035166.02 of the Revised Code so provide, "total 34404
facility costs" may exclude costs associated with providing care 34405
to recipients of any of the governmental programs listed in 34406
division (B) of that section.34407

       (K)(J) "Uncompensated care" means bad debt and charity care.34408

       Sec. 5112.03.        Sec. 5166.02.  (A) The director of job and family34409
serviceshealth care administration shall adopt, and may amend and 34410
rescind, rules in accordance with Chapter 119. of the Revised Code 34411
for the purpose of administering sections 5112.015166.01 to 34412
5112.215166.14 of the Revised Code, including rules that do all 34413
of the following:34414

       (1) Define as a "disproportionate share hospital" any34415
hospital included under subsection (b) of section 1923 of the34416
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.34417
1396r-4(b), as amended, and any other hospital the director34418
determines appropriate;34419

       (2) Prescribe the form for submission of cost reports under34420
section 5112.045166.03 of the Revised Code;34421

       (3) Establish, in accordance with division (A) of section34422
5112.065166.05 of the Revised Code, the assessment rate or rates34423
to be applied to hospitals under that section;34424

       (4) Establish schedules for hospitals to pay installments on34425
their assessments under section 5112.065166.05 of the Revised 34426
Code and for governmental hospitals to pay installments on their34427
intergovernmental transfers under section 5112.075166.06 of the 34428
Revised Code;34429

       (5) Establish procedures to notify hospitals of adjustments34430
made under division (B)(2)(b) of section 5112.065166.05 of the 34431
Revised Code in the amount of installments on their assessment;34432

       (6) Establish procedures to notify hospitals of adjustments34433
made under division (D) of section 5112.095166.08 of the Revised 34434
Code in the total amount of their assessment and to adjust for the34435
remainder of the program year the amount of the installments on34436
the assessments;34437

       (7) Establish, in accordance with section 5112.085166.07 of 34438
the Revised Code, the methodology for paying hospitals under that34439
section.34440

       The director shall consult with hospitals when adopting the34441
rules required by divisions (A)(4) and (5) of this section in34442
order to minimize hospitals' cash flow difficulties.34443

       (B) Rules adopted under this section may provide that "total34444
facility costs" excludes costs associated with any of the34445
following:34446

       (1) Recipients of the medical assistancemedicaid program;34447

       (2) Recipients of financial assistance provided under Chapter 34448
5115. of the Revised Code;34449

       (3) Recipients of the disability medical assistance provided34450
under Chapter 5115. of the Revised Codeprogram;34451

       (4) Recipients of the program for medically handicapped34452
children established under section 3701.023 of the Revised Code;34453

       (5) Recipients of the medicare program established under34454
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 4234455
U.S.C.A. 301, as amended:;34456

       (6) Recipients of Title V of the "Social Security Act of 34457
1935";34458

       (7) Any other category of costs deemed appropriate by the34459
director in accordance with Title XIX of the "Social Security Act"34460
and the rules adopted under that titlefederal law, including 34461
administrative regulations, governing the medicaid program.34462

       Sec. 5112.04.        Sec. 5166.03.  (A) Except as provided in division (C) 34463
of this section, each hospital, on or before the first day of July34464
of each year or at a later date approved by the director of job 34465
and family serviceshealth care administration, shall submit to 34466
the department of job and family serviceshealth care 34467
administration a financial statement for the preceding calendar 34468
year that accurately reflects the income, expenses, assets,34469
liabilities, and net worth of the hospital, and accompanying34470
notes. A hospital that has a fiscal year different from the34471
calendar year shall file its financial statement within one34472
hundred eighty days of the end of its fiscal year or at a later34473
date approved by the director of job and family serviceshealth 34474
care administration. The financial statement shall be prepared by 34475
an independent certified public accountant and reflect an official 34476
audit report prepared in a manner consistent with generally 34477
accepted accounting principles. The financial statement shall, to 34478
the extent that the hospital has sufficient financial records, 34479
show bad debt and charity care separately from courtesy care and 34480
contractual allowances.34481

       (B) Except as provided in division (C) of this section, each34482
hospital, within one hundred eighty days after the end of the34483
hospital's cost reporting period, shall submit to the department a34484
cost report in a format prescribed in rules adopted by the34485
director of job and family services under section 5112.035166.0234486
of the Revised Code. The department shall grant a hospital an 34487
extension of the one hundred eighty day period if the health care34488
financing administration of the United States department of health 34489
and human services extends the date by which the hospital must 34490
submit its cost report for the hospital's cost reporting period.34491

       (C) The director of job and family serviceshealth care 34492
administration may adopt rules under section 5112.035166.02 of 34493
the Revised Code specifying financial information that must be 34494
submitted by hospitals for which no financial statement or cost 34495
report is available. The rules shall specify deadlines for 34496
submitting the information. Each such hospital shall submit the 34497
information specified in the rules not later than the deadline 34498
specified in the rules.34499

       Sec. 5112.05.        Sec. 5166.04.  The requirements of sections 5112.0634500
5166.05 to 5112.095166.08 of the Revised Code apply only as long 34501
as the United States health care financing administration34502
department of health and human services determines that the34503
assessment imposed under section 5112.065166.05 of the Revised 34504
Code is a permissible health care-related tax pursuant to section 34505
1903(w) of the "Social Security Act," 49 Stat. 620 (1935), 42 34506
U.S.C.A. 1396b(w), as amended. Whenever the department of job and 34507
family serviceshealth care administration is informed that the 34508
assessment is an impermissible health care-related tax, the 34509
department shall promptly refund to each hospital the amount of 34510
money currently in the hospital care assurance program fund 34511
created by section 5112.185166.12 of the Revised Code that has 34512
been paid by the hospital under section 5112.065166.05 or 5112.0734513
5166.06 of the Revised Code, plus any investment earnings on that34514
amount.34515

       Sec. 5112.06.        Sec. 5166.05.  (A) For the purpose of distributing34516
funds to hospitals under the medical assistancemedicaid program 34517
pursuant to sections 5112.015166.01 to 5112.215166.14 of the 34518
Revised Code and depositing funds into the legislative budget 34519
services fund under section 5112.195166.13 of the Revised Code 34520
and into the health care services administration fund created 34521
under section 5111.945161.15 of the Revised Code, there is hereby34522
imposed an assessment on all hospitals. Each hospital's assessment 34523
shall be based on total facility costs. All hospitals shall be34524
assessed according to the rate or rates established each program 34525
year by the department of job and family serviceshealth care 34526
administration in rules adopted under section 5112.035166.02 of 34527
the Revised Code. The department shall assess all hospitals 34528
uniformly and in a manner consistent with federal statutes and34529
regulations. During any program year, the department shall not 34530
assess any hospital more than two per cent of the hospital's total 34531
facility costs.34532

       The department shall establish an assessment rate or rates34533
each program year that will do both of the following:34534

       (1) Yield funds that, when combined with intergovernmental34535
transfers and federal matching funds, will produce a program of34536
sufficient size to pay a substantial portion of the indigent care34537
provided by hospitals;34538

       (2) Yield funds that, when combined with intergovernmental34539
transfers and federal matching funds, will produce amounts for34540
distribution to disproportionate share hospitals that do not34541
exceed, in the aggregate, the limits prescribed by the United34542
States health care financing administrationdepartment of health 34543
and human services under subsection (f) of section 1923 of the34544
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.34545
1396r-4(f), as amended.34546

       (B)(1) Except as provided in division (B)(3) of this section, 34547
each hospital shall pay its assessment in periodic installments in 34548
accordance with a schedule established by the director of job and 34549
family serviceshealth care administration in rules adopted under34550
section 5112.035166.02 of the Revised Code.34551

       (2) The installments shall be equal in amount, unless either34552
of the following applies:34553

       (a) The department makes adjustments during a program year34554
under division (D) of section 5112.095166.08 of the Revised Code 34555
in the total amount of hospitals' assessments;34556

       (b) The director of job and family serviceshealth care 34557
administration determines that adjustments in the amounts of 34558
installments are necessary for the administration of sections 34559
5112.015166.01 to 5112.215166.14 of the Revised Code and that 34560
unequal installments will not create cash flow difficulties for 34561
hospitals.34562

       (3) The director may adopt rules under section 5112.0334563
5166.02 of the Revised Code establishing alternate schedules for 34564
hospitals to pay assessments under this section in order to reduce 34565
hospitals' cash flow difficulties.34566

       Sec. 5112.07.        Sec. 5166.06.  (A) The department of job and family34567
serviceshealth care administration may require governmental 34568
hospitals to make intergovernmental transfers each program year34569
for the purpose of distributing funds to hospitals under the 34570
medical assistancemedicaid program pursuant to sections 5112.0134571
5166.01 to 5112.215166.14 of the Revised Code and depositing34572
funds into the legislative budget services fund under section34573
5112.195166.13 of the Revised Code and into the health care 34574
services administration fund created under section 5111.945161.1534575
of the Revised Code. The department shall not require transfers in 34576
an amount that, when combined with hospital assessments paid under 34577
section 5112.065166.05 of the Revised Code and federal matching 34578
funds, produce amounts for distribution to disproportionate share 34579
hospitals that, in the aggregate, exceed limits prescribed by the 34580
United States health care financing administrationdepartment of 34581
health and human services under subsection (f) of section 1923 of 34582
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.34583
1396r-4(f), as amended.34584

       (B) Before or during each program year, the department shall34585
notify each governmental hospital of the amount of the34586
intergovernmental transfer it is required to make during the34587
program year. Each governmental hospital shall make34588
intergovernmental transfers as required by the department under34589
this section in periodic installments, executed by electronic fund34590
transfer, in accordance with a schedule established in rules34591
adopted under section 5112.035166.02 of the Revised Code.34592

       Sec. 5112.08.        Sec. 5166.07.  The director of job and family 34593
serviceshealth care administration shall adopt rules under 34594
section 5112.035166.02 of the Revised Code establishing a34595
methodology to pay hospitals that is sufficient to expend all34596
money in the indigent care pool. Under the rules:34597

       (A) The department of job and family serviceshealth care 34598
administration may classify similar hospitals into groups and 34599
allocate funds for distribution within each group.34600

       (B) The department shall establish a method of allocating34601
funds to hospitals, taking into consideration the relative amount34602
of indigent care provided by each hospital or group of hospitals.34603
The amount to be allocated shall be based on any combination of34604
the following indicators of indigent care that the director34605
considers appropriate:34606

       (1) Total costs, volume, or proportion of services to 34607
medicaid recipients of the medical assistance program, including34608
recipients enrolled in health insuring corporations;34609

       (2) Total costs, volume, or proportion of services to34610
low-income patients in addition to medicaid recipients of the 34611
medical assistance program, which may include recipients of Title 34612
V of the "Social Security Act of 1935," 49 Stat. 620 (1935), 42 34613
U.S.C.A. 301, as amended, and recipients of financial or medical34614
assistance provided under Chapter 5115. of the Revised Code, and 34615
recipients of the disability medical assistance program;34616

       (3) The amount of uncompensated care provided by the hospital 34617
or group of hospitals;34618

       (4) Other factors that the director considers to be34619
appropriate indicators of indigent care.34620

       (C) The department shall distribute funds to each hospital or 34621
group of hospitals in a manner that first may provide for an34622
additional distribution to individual hospitals that provide a34623
high proportion of indigent care in relation to the total care34624
provided by the hospital or in relation to other hospitals. The34625
department shall establish a formula to distribute the remainder34626
of the funds. The formula shall be consistent with section 1923 of 34627
the "Social Security Act," 42 U.S.C.A. 1396r-4, as amended, shall 34628
beand based on any combination of the indicators of indigent care34629
listed in division (B) of this section that the director considers 34630
appropriate.34631

       (D) The department shall distribute funds to each hospital in34632
installments not later than ten working days after the deadline34633
established in rules for each hospital to pay an installment on34634
its assessment under section 5112.065166.05 of the Revised Code. 34635
In the case of a governmental hospital that makes 34636
intergovernmental transfers, the department shall pay an 34637
installment under this section not later than ten working days 34638
after the earlier of that deadline or the deadline established in 34639
rules for the governmental hospital to pay an installment on its34640
intergovernmental transfer. If the amount in the hospital care34641
assurance program fund created under section 5112.185166.12 of 34642
the Revised Code and the portion of the health care - federal fund34643
created under section 5111.9435161.18 of the Revised Code that is 34644
credited to that fund pursuant to division (B) of section 5112.1834645
5166.12 of the Revised Code are insufficient to make the total34646
distributions for which hospitals are eligible to receive in any34647
period, the department shall reduce the amount of each34648
distribution by the percentage by which the amount and portion are34649
insufficient. The department shall distribute to hospitals any34650
amounts not distributed in the period in which they are due as34651
soon as moneys are available in the funds.34652

       Sec. 5112.09.        Sec. 5166.08.  (A) Before or during each program 34653
year, the department of job and family serviceshealth care 34654
administration shall mail to each hospital by certified mail, 34655
return receipt requested, the preliminary determination of the 34656
amount that the hospital is assessed under section 5112.065166.0534657
of the Revised Code during the program year. The preliminary 34658
determination of a hospital's assessment shall be calculated for a 34659
cost-reporting period that is specified in rules adopted under 34660
section 5112.035166.02 of the Revised Code.34661

       The department shall consult with hospitals each year when34662
determining the date on which it will mail the preliminary34663
determinations in order to minimize hospitals' cash flow34664
difficulties.34665

       If no hospital submits a request for reconsideration under34666
division (B) of this section, the preliminary determination34667
constitutes the final reconciliation of each hospital's assessment34668
under section 5112.065166.05 of the Revised Code. The final34669
reconciliation is subject to adjustments under division (D) of34670
this section.34671

       (B) Not later than fourteen days after the preliminary34672
determinations are mailed, any hospital may submit to the34673
department a written request to reconsider the preliminary34674
determinations. The request shall be accompanied by written34675
materials setting forth the basis for the reconsideration. If one34676
or more hospitals submit a request, the department shall hold a34677
public hearing not later than thirty days after the preliminary34678
determinations are mailed to reconsider the preliminary34679
determinations. The department shall mail to each hospital a34680
written notice of the date, time, and place of the hearing at34681
least ten days prior to the hearing. On the basis of the evidence34682
submitted to the department or presented at the public hearing,34683
the department shall reconsider and may adjust the preliminary34684
determinations. The result of the reconsideration is the final34685
reconciliation of the hospital's assessment under section 5112.0634686
5166.05 of the Revised Code. The final reconciliation is subject 34687
to adjustments under division (D) of this section.34688

       (C) The department shall mail to each hospital a written34689
notice of its assessment for the program year under the final34690
reconciliation. A hospital may appeal the final reconciliation of34691
its assessment to the court of common pleas of Franklin county.34692
While a judicial appeal is pending, the hospital shall pay, in34693
accordance with the schedules required by division (B) of section34694
5112.065166.05 of the Revised Code, any amount of its assessment 34695
that is not in dispute into the hospital care assurance program 34696
fund created in section 5112.185166.12 of the Revised Code.34697

       (D) In the course of any program year, the department may34698
adjust the assessment rate or rates established in rules pursuant34699
to section 5112.065166.05 of the Revised Code or adjust the 34700
amounts of intergovernmental transfers required under section 34701
5112.075166.06 of the Revised Code and, as a result of the 34702
adjustment, adjust each hospital's assessment and 34703
intergovernmental transfer, to reflect refinements made by the 34704
United States health care financing administrationdepartment of 34705
health and human services during that program year to the limits 34706
it prescribed under subsection (f) of section 1923 of the "Social34707
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 1396r-4(f), as34708
amended. When adjusted, the assessment rate or rates must comply34709
with division (A) of section 5112.065166.05 of the Revised Code. 34710
An adjusted intergovernmental transfer must comply with division34711
(A) of section 5112.075166.06 of the Revised Code. The department 34712
shall notify hospitals of adjustments made under this division and34713
adjust for the remainder of the program year the installments paid34714
by hospitals under sections 5112.065166.05 and 5112.075166.06 of 34715
the Revised Code in accordance with rules adopted under section 34716
5112.035166.02 of the Revised Code.34717

       Sec. 5112.10.        Sec. 5166.09.  The department of job and family 34718
serviceshealth care administration shall operate the hospital34719
care assurance program established by sections 5112.015166.01 to 34720
5112.215166.14 of the Revised Code on a program year basis. The 34721
department shall complete all program requirements on or before 34722
the thirtieth day of September each year.34723

       Sec. 5112.11.        Sec. 5166.10.  Except for moneys deposited into the34724
legislative budget services fund under section 5112.195166.13 of 34725
the Revised Code and the health care services administration fund34726
created under section 5111.945161.15 of the Revised Code, the 34727
department of job and family serviceshealth care administration34728
shall not use money paid to the department under sections 5112.0634729
5166.05 and 5112.075166.06 of the Revised Code or money that the 34730
department pays to hospitals under section 5112.085166.07 of the 34731
Revised Code to replace any funds appropriated by the general 34732
assembly for the medical assistancemedicaid program.34733

       Sec. 5112.17.        Sec. 5166.11.  (A) As used in this section:34734

       (1) "Federal poverty guideline" means the official poverty34735
guideline as revised annually by the United States secretary of34736
health and human services in accordance with section 673 of the34737
"Community Service Block Grant Act," 95 Stat. 511 (1981), 4234738
U.S.C.A. 9902, as amended, for a family size equal to the size of34739
the family of the person whose income is being determined.34740

       (2) "Third-party payer" means any private or public entity or 34741
program that may be liable by law or contract to make payment to 34742
or on behalf of an individual for health care services.34743
"Third-party payer" does not include a hospital.34744

       (B) Each hospital that receives funds distributed under 34745
sections 5112.015166.01 to 5112.215166.14 of the Revised Code 34746
shall provide, without charge to the individual, basic, medically 34747
necessary hospital-level services to individuals who are residents 34748
of this state, are not recipients of the medical assistance34749
medicaid program, and whose income is at or below the federal34750
poverty guideline. Recipients of disability financial assistance 34751
and recipients of disability medical assistance provided under 34752
Chapter 5115. of the Revised Code and recipients of the disability 34753
medical assistance program qualify for services under this 34754
section. The director of job and family serviceshealth care 34755
administration shall adopt rules under section 5112.035166.02 of 34756
the Revised Code specifying the hospital services to be provided 34757
under this section.34758

       (C) Nothing in this section shall be construed to prevent a 34759
hospital from requiring an individual to apply for eligibility 34760
under the medical assistancemedicaid program before the hospital 34761
processes an application under this section. Hospitals may bill 34762
any third-party payer for services rendered under this section. 34763
Hospitals may bill the medical assistancemedicaid program, in 34764
accordance with Chapter 5111.5163. of the Revised Code and the 34765
rules adopted under that chaptersection 5163.15 of the Revised 34766
Code, for services rendered under this section if the individual 34767
becomes a recipient of the program. Hospitals may bill individuals 34768
for services under this section if all of the following apply:34769

       (1) The hospital has an established post-billing procedure34770
for determining the individual's income and canceling the charges34771
if the individual is found to qualify for services under this34772
section.34773

       (2) The initial bill, and at least the first follow-up bill, 34774
is accompanied by a written statement that does all of the34775
following:34776

       (a) Explains that individuals with income at or below the34777
federal poverty guideline are eligible for services without34778
charge;34779

       (b) Specifies the federal poverty guideline for individuals 34780
and families of various sizes at the time the bill is sent;34781

       (c) Describes the procedure required by division (C)(1) of34782
this section.34783

       (3) The hospital complies with any additional rules the34784
department adopts under section 5112.035166.02 of the Revised 34785
Code.34786

       Notwithstanding division (B) of this section, a hospital34787
providing care to an individual under this section is subrogated34788
to the rights of any individual to receive compensation or34789
benefits from any person or governmental entity for the hospital34790
goods and services rendered.34791

       (D) Each hospital shall collect and report to the department, 34792
in the form and manner prescribed by the department, information 34793
on the number and identity of patients served pursuant to this 34794
section.34795

       (E) This section applies beginning May 22, 1992, regardless 34796
of whether the department has adopted rules specifying the 34797
services to be provided. Nothing in this section alters the scope 34798
or limits the obligation of any governmental entity or program, 34799
including the program awarding reparations to victims of crime 34800
under sections 2743.51 to 2743.72 of the Revised Code and the34801
program for medically handicapped children established under34802
section 3701.023 of the Revised Code, to pay for hospital services 34803
in accordance with state or local law.34804

       Sec. 5112.18.        Sec. 5166.12.  (A) Except as provided in section 34805
5112.195166.13 of the Revised Code, all payments of assessments 34806
by hospitals under section 5112.065166.05 of the Revised Code and 34807
all intergovernmental transfers under section 5112.075166.06 of 34808
the Revised Code shall be deposited in the state treasury to the 34809
credit of the hospital care assurance program fund, hereby 34810
created. All investment earnings of the hospital care assurance 34811
program fund shall be credited to the fund. The department of job 34812
and family serviceshealth care administration shall maintain 34813
records that show the amount of money in the hospital care 34814
assurance program fund at any time that has been paid by each34815
hospital and the amount of any investment earnings on that amount.34816
All moneys credited to the hospital care assurance program fund34817
shall be used solely to make payments to hospitals under division34818
(D) of this section and section 5112.085166.07 of the Revised 34819
Code.34820

       (B) All federal matching funds received as a result of the34821
department distributing funds from the hospital care assurance34822
program fund to hospitals under section 5112.085166.07 of the 34823
Revised Code shall be credited to the health care - federal fund 34824
created under section 5111.9435161.18 of the Revised Code. 34825

       (C) All distributions of funds to hospitals under section34826
5112.085166.07 of the Revised Code are conditional on:34827

       (1) Expiration of the time for appeals under section 5112.0934828
5166.08 of the Revised Code without the filing of an appeal, or on 34829
court determinations, in the event of appeals, that the hospital 34830
is entitled to the funds;34831

       (2) The sum of the following being sufficient to distribute 34832
the funds after the final determination of any appeals:34833

       (a) The available money in the hospital care assurance 34834
program fund;34835

       (b) The available portion of the money in the health care - 34836
federal fund that is credited to that fund pursuant to division 34837
(B) of this section.34838

       (3) The hospital's compliance with section 5112.175166.11 of 34839
the Revised Code.34840

       (D) If an audit conducted by the department of the amounts of 34841
payments made and funds received by hospitals under sections34842
5112.06, 5112.07, and 5112.085166.05, 5166.06, and 5166.07 of the 34843
Revised Code identifies amounts that, due to errors by the 34844
department, a hospital should not have been required to pay but 34845
did pay, should have been required to pay but did not pay, should 34846
not have received but did receive, or should have received but did 34847
not receive, the department shall:34848

       (1) Make payments to any hospital that the audit reveals paid 34849
amounts it should not have been required to pay or did not receive 34850
amounts it should have received;34851

       (2) Take action to recover from a hospital any amounts that34852
the audit reveals it should have been required to pay but did not34853
pay or that it should not have received but did receive.34854

       Payments made under division (D)(1) of this section shall be34855
made from the hospital care assurance program fund. Amounts34856
recovered under division (D)(2) of this section shall be deposited34857
to the credit of that fund. Any hospital may appeal the amount the 34858
hospital is to be paid under division (D)(1) or the amount that is 34859
to be recovered from the hospital under division (D)(2) of this 34860
section to the court of common pleas of Franklin county.34861

       Sec. 5112.19.        Sec. 5166.13.  From the first installment of 34862
assessments paid under section 5112.065166.05 of the Revised Code 34863
and intergovernmental transfers made under section 5112.075166.0634864
of the Revised Code during each program year beginning in an 34865
odd-numbered calendar year, the department of job and family 34866
serviceshealth care administration shall deposit into the state34867
treasury to the credit of the legislative budget services fund,34868
which is hereby created, a total amount equal to the amount by34869
which the biennial appropriation from that fund exceeds the amount34870
of unexpended, unencumbered moneys in that fund. All investment34871
earnings of the legislative budget services fund shall be credited34872
to that fund. Money in the legislative budget services fund shall34873
be used solely to pay the expenses of the legislative budget34874
office of the legislative service commission.34875

       Sec. 5112.21.        Sec. 5166.14.  Except as specifically required by 34876
sections 5112.015166.01 to 5112.195166.13 of the Revised Code, 34877
information filed under those sections shall not include any 34878
patient-identifying material. Information that includes 34879
patient-identifying material is not a public record under section 34880
149.43 of the Revised Code, and no patient-identifying material 34881
shall be released publicly by the department of job and family 34882
serviceshealth care administration or by any person under34883
contract with the department who has access to such information.34884

       Sec. 3721.50.        Sec. 5166.20.  As used in sections 3721.505166.20 to 34885
3721.585166.30 of the Revised Code:34886

       (A) "Hospital" has the same meaning as in section 3727.01 of 34887
the Revised Code.34888

       (B) "Inpatient days" means all days during which a resident 34889
of a nursing facility, regardless of payment source, occupies a 34890
bed in the nursing facility that is included in the facility's 34891
certified capacity under Title XIXthe medicaid program. 34892
Therapeutic or hospital leave days for which payment is made under 34893
section 5111.265164.37 of the Revised Code are considered 34894
inpatient days proportionate to the percentage of the facility's 34895
per resident per day rate paid for those days.34896

       (C) "Medicaid" has the same meaning as in section 5111.01 of 34897
the Revised Code.34898

       (D) "Medicaid day" means all days during which a resident who 34899
is a medicaid recipient occupies a bed in a nursing facility that 34900
is included in the facility's certified capacity under Title XIX34901
the medicaid program. Therapeutic or hospital leave days for which 34902
payment is made under section 5111.265164.37 of the Revised Code 34903
are considered medicaid days proportionate to the percentage of 34904
the nursing facility's per resident per day rate for those days.34905

       (E)(D) "Nursing facility" has the same meaning as in section 34906
5111.205164.01 of the Revised Code.34907

       (F)(E)(1) "Nursing home" means all of the following:34908

       (a) A nursing home licensed under section 3721.02 or 3721.09 34909
of the Revised Code, including any part of a home for the aging 34910
licensed as a nursing home;34911

       (b) A facility or part of a facility, other than a hospital, 34912
that is certified as a skilled nursing facility under Title XVIII34913
the medicare program;34914

       (c) A nursing facility, other than a portion of a hospital 34915
certified as a nursing facility.34916

       (2) "Nursing home" does not include any of the following:34917

       (a) A county home, county nursing home, or district home 34918
operated pursuant to Chapter 5155. of the Revised Code;34919

       (b) A nursing home maintained and operated by the Ohio 34920
veterans' home agency under section 5907.01 of the Revised Code;34921

        (c) A nursing home or part of a nursing home licensed under 34922
section 3721.02 or 3721.09 of the Revised Code that is certified 34923
as an intermediate care facility for the mentally retarded under 34924
Title XIXthe medicaid program.34925

       (G) "Title XIX" means Title XIX of the "Social Security Act," 34926
79 Stat. 286 (1965), 42 U.S.C. 1396, as amended.34927

       (H) "Title XVIII" means Title XVIII of the "Social Security 34928
Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended.34929

       Sec. 3721.51.        Sec. 5166.21.  The department of job and family 34930
serviceshealth care administration shall do all of the following:34931

       (A) Subject to division (C) of this section and for the 34932
purposes specified in sections 3721.565166.27 and 3721.56134933
5166.28 of the Revised Code, determine an annual franchise permit 34934
fee on each nursing home in an amount equal to six dollars and 34935
twenty-five cents, multiplied by the product of the following:34936

       (1) The number of beds licensed as nursing home beds, plus34937
any other beds certified as skilled nursing facility beds under34938
Title XVIIIthe medicare program or nursing facility beds under 34939
Title XIXthe medicaid program on the first day of May of the 34940
calendar year in which the fee is determined pursuant to division 34941
(A) of section 3721.535166.23 of the Revised Code;34942

       (2) The number of days in the fiscal year beginning on the 34943
first day of July of the calendar year in which the fee is34944
determined pursuant to division (A) of section 3721.535166.23 of 34945
the Revised Code.34946

       (B) Subject to division (C) of this section and for the 34947
purposes specified in sections 3721.565166.27 and 3721.56134948
5166.28 of the Revised Code, determine an annual franchise34949
permit fee on each hospital in an amount equal to six dollars 34950
and twenty-five cents, multiplied by the product of the34951
following:34952

       (1) The number of beds registered pursuant to section 3701.07 34953
of the Revised Code as skilled nursing facility beds or long-term 34954
care beds, plus any other beds licensed as nursing home beds under 34955
section 3721.02 or 3721.09 of the Revised Code, on the first day 34956
of May of the calendar year in which the fee is determined 34957
pursuant to division (A) of section 3721.535166.23 of the Revised 34958
Code;34959

       (2) The number of days in the fiscal year beginning on the 34960
first day of July of the calendar year in which the fee is34961
determined pursuant to division (A) of section 3721.535166.23 of 34962
the Revised Code.34963

       (C) If the United States centers for medicare and medicaid34964
services determines that the franchise permit fee established by34965
sections 3721.505166.20 to 3721.585166.30 of the Revised Code is 34966
an impermissible health care-related tax under section 1903(w) of34967
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.34968
1396b(w), as amended, take all necessary actions to cease 34969
implementation of sections 3721.505166.20 to 3721.585166.30 of 34970
the Revised Code in accordance with rules adopted under section 34971
3721.585166.30 of the Revised Code.34972

       Sec. 3721.52.        Sec. 5166.22.  (A) For the purpose of the fee under34973
division (A) of section 3721.515166.21 of the Revised Code, the 34974
department of health shall, not later than the first day of each 34975
June, report to the department of job and family serviceshealth 34976
care administration the number of beds in each nursing home 34977
licensed on the preceding first day of May under section 3721.02 34978
or 3721.09 of the Revised Code or certified on that date under 34979
Title XVIII or XIXthe medicare or medicaid program.34980

       (B) For the purpose of the fee under division (B) of section34981
3721.515166.21 of the Revised Code, the department of health34982
shall, not later than the first day of each June, report to the34983
department of job and family serviceshealth care administration34984
the number of beds in each hospital registered on the preceding34985
first day of May pursuant to section 3701.07 of the Revised Code34986
as skilled nursing facility or long-term care beds or licensed on34987
that date under section 3721.02 or 3721.09 of the Revised Code as34988
nursing home beds.34989

       Sec. 3721.53.        Sec. 5166.23.  (A) Not later than the fifteenth day 34990
of August of each year, the department of job and family services34991
health care administration shall determine the annual franchise 34992
permit fee for each nursing home in accordance with division (A) 34993
of section 3721.515166.21 of the Revised Code and the annual 34994
franchise permit fee for each hospital in accordance with division 34995
(B) of that section.34996

       (B) Not later than the first day of September of each year,34997
the department shall mail to each nursing home and hospital notice34998
of the amount of the franchise permit fee that has been determined34999
for the nursing home or hospital.35000

       (C) Each nursing home and hospital shall pay its fee under35001
section 3721.515166.21 of the Revised Code to the department in 35002
quarterly installment payments not later than forty-five days 35003
after the last day of each September, December, March, and June.35004

       (D) No nursing home or hospital shall directly bill its35005
residents for the fee paid under this section, or otherwise35006
directly pass the fee through to its residents.35007

       Sec. 3721.54.        Sec. 5166.24.  If a nursing home or hospital fails to 35008
pay the full amount of a franchise permit fee installment when 35009
due, the department of job and family serviceshealth care 35010
administration may assess a five per cent penalty on the amount 35011
due for each month or fraction thereof the installment is overdue.35012

       Sec. 3721.541.        Sec. 5166.25.  (A) In addition to assessing a 35013
penalty pursuant to section 3721.545166.24 of the Revised Code, 35014
the department of job and family serviceshealth care 35015
administration may do any of the following if a nursing facility 35016
or hospital fails to pay the full amount of a franchise permit 35017
fee installment when due:35018

        (1) Withhold an amount less than or equal to the installment 35019
and penalty assessed under section 3721.545166.24 of the Revised 35020
Code from a medicaid payment due the nursing facility or hospital 35021
until the nursing facility or hospital pays the installment and 35022
penalty;35023

        (2) Offset an amount less than or equal to the installment 35024
and penalty assessed under section 3721.545166.24 of the Revised 35025
Code from a Medicaidmedicaid payment due the nursing facility or 35026
hospital;35027

       (3) Terminate the nursing facility or hospital's medicaid 35028
provider agreement.35029

        (B) The department may offset a medicaid payment under 35030
division (A) of this section without providing notice to the 35031
nursing facility or hospital and without conducting an 35032
adjudication under Chapter 119. of the Revised Code.35033

       Sec. 3721.55.        Sec. 5166.26.  (A) A nursing home or hospital may 35034
appeal the fee imposed under section 3721.515166.21 of the 35035
Revised Code solely on the grounds that the department of job and 35036
family serviceshealth care administration committed a material 35037
error in determining the amount of the fee. A request for an 35038
appeal must be received by the department not later than fifteen 35039
days after the date the department mails the notice of the fee and 35040
must include written materials setting forth the basis for the 35041
appeal.35042

       (B) If a nursing home or hospital submits a request for an35043
appeal within the time required under division (A) of this35044
section, the department of job and family serviceshealth care 35045
administration shall hold a public hearing in Columbus not later 35046
than thirty days after the date the department receives the 35047
request for an appeal. The department shall, not later than ten 35048
days before the date of the hearing, mail a notice of the date, 35049
time, and place of the hearing to the nursing home or hospital. 35050
The department may hear all the requested appeals in one public 35051
hearing.35052

       (C) On the basis of the evidence presented at the hearing or35053
any other evidence submitted by the nursing home or hospital, the35054
department may adjust a fee. The department's decision is final.35055

       Sec. 3721.56.        Sec. 5166.27.  There is hereby created in the state 35056
treasury the home- and community-based services for the aged 35057
fund. Sixteen per cent of all payments and penalties paid by 35058
nursing homes and hospitals under sections 3721.535166.23 and 35059
3721.545166.24 of the Revised Code shall be deposited into the 35060
fund. The departments of job and family serviceshealth care 35061
administration and aging shall use the moneys in the fund to 35062
fund the following in accordance with rules adopted under section 35063
3721.585166.30 of the Revised Code:35064

       (A) The medicaid program established under Chapter 5111. of 35065
the Revised Code, including the PASSPORT program established under 35066
section 173.40 of the Revised Code;35067

       (B) The residential state supplement program established35068
under section 173.355160.80 of the Revised Code.35069

       Sec. 3721.561.        Sec. 5166.28.  (A) There is hereby created in the 35070
state treasury the nursing facility stabilization fund. All 35071
payments and penalties paid by nursing homes and hospitals under 35072
sections 3721.535166.23 and 3721.545166.24 of the Revised Code 35073
that are not deposited into the home and community-based services 35074
for the aged fund shall be deposited into the fund. The department 35075
of job and family serviceshealth care administration shall use 35076
the money in the fund to make medicaid payments to nursing 35077
facilities.35078

        (B) Any money remaining in the nursing facility stabilization 35079
fund after payments specified in division (A) of this section are 35080
made shall be retained in the fund. Any interest or other 35081
investment proceeds earned on money in the fund shall be credited 35082
to the fund and used to make medicaid payments in accordance with 35083
division (A) of this section.35084

       Sec. 3721.57.        Sec. 5166.29.  The department of job and family 35085
serviceshealth care administration may make any investigation it35086
considers appropriate to obtain information necessary to fulfill 35087
its duties under sections 3721.505166.20 to 3721.585166.30 of 35088
the Revised Code. At the request of the department, the attorney 35089
general shall aid in any such investigations. The attorney general 35090
shall institute and prosecute all necessary actions for the35091
enforcement of sections 3721.505166.20 to 3721.585166.30 of the35092
Revised Code, except that at the request of the attorney general,35093
the county prosecutor of the county in which a nursing home or35094
hospital that has failed to comply with sections 3721.505166.2035095
to 3721.585166.30 of the Revised Code is located shall institute 35096
and prosecute any necessary action against the nursing home or35097
hospital.35098

       Sec. 3721.58.        Sec. 5166.30.  The director of job and family 35099
serviceshealth care administration shall adopt rules in 35100
accordance with Chapter 119. of the Revised Code to do all of the 35101
following:35102

       (A) Prescribe the actions the department of job and family35103
serviceshealth care administration will take to cease 35104
implementation of sections 3721.505166.20 through 3721.575166.2935105
of the Revised Code if the United States centers for medicare and 35106
medicaid services determines that the franchise permit fee35107
established by those sections is an impermissible health-care35108
related tax under section 1903(w) of the "Social Security Act," 4935109
Stat. 620 (1935), 42 U.S.C. 1396b(w), as amended;35110

       (B) Establish the method of distributing moneys in the home35111
and community-based services for the aged fund created under35112
section 3721.565166.27 of the Revised Code;35113

       (C) Establish any requirements or procedures the director35114
considers necessary to implement sections 3721.505166.20 to 35115
3721.585166.30 of the Revised Code.35116

       Sec. 5112.30.        Sec. 5166.40.  As used in sections 5112.305166.40 to 35117
5112.395166.50 of the Revised Code:35118

       (A) "Intermediate, "intermediate care facility for the 35119
mentally retarded" has the same meaning as in section 5111.2035120
5164.01 of the Revised Code, except that it does not include any35121
such facility operated by the department of mental retardation and35122
developmental disabilities.35123

       (B) "Medicaid" has the same meaning as in section 5111.01 of 35124
the Revised Code.35125

       Sec. 5112.31.        Sec. 5166.41.  The department of job and family 35126
serviceshealth care administration shall do all of the 35127
following:35128

       (A) For the purposes specified in sections 5112.375166.4835129
and 5112.3715166.481 of the Revised Code, annually assess each 35130
intermediate care facility for the mentally retarded a franchise 35131
permit fee equal to eleven dollars and ninety-eight cents 35132
multiplied by the product of the following:35133

       (1) The number of beds certified under Title XIX of the35134
"Social Security Act"for the medicaid program on the first day of 35135
May of the calendar year in which the assessment is determined 35136
pursuant to division (A) of section 5112.335166.44 of the 35137
Revised Code;35138

       (2) The number of days in the fiscal year beginning on the35139
first day of July of the same calendar year.35140

       (B) Beginning July 1, 2009, and the first day of each July 35141
thereafter, adjust fees determined under division (A) of this35142
section in accordance with the composite inflation factor 35143
established in rules adopted under section 5112.395166.50 of the 35144
Revised Code.35145

       (C) If the United States secretary of health and human 35146
services determines that the franchise permit fee established by 35147
sections 5112.305166.40 to 5112.395166.50 of the Revised Code 35148
would be an impermissible health care-related tax under section 35149
1903(w) of the "Social Security Act," 42 U.S.C.A. 1396b(w), as 35150
amended, take all necessary actions to cease implementation of 35151
those sections in accordance with rules adopted under section 35152
5112.395166.50 of the Revised Code.35153

       Sec. 5112.32.        Sec. 5166.43.  For the purpose of the franchise 35154
permit fee imposed under section 5112.315166.41 of the Revised 35155
Code, the department of mental retardation and developmental 35156
disabilities shall:35157

       (A) Not later than August 1, 1993, report to the department 35158
of job and family serviceshealth care administration the number 35159
of beds in each intermediate care facility for the mentally35160
retarded certified on July 1, 1993, under Title XIX of the "Social 35161
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended35162
for the medicaid program;35163

       (B) Not later than June 1, 1994, and the first day of each 35164
June thereafter, report to the department of job and family 35165
serviceshealth care administration the number of beds in each 35166
such facility certified on the preceding first day of May under 35167
that title.35168

       Sec. 5112.33.        Sec. 5166.44.  (A) Not later than the fifteenth day 35169
of August of each year, the department of job and family services35170
health care administration shall determine the annual franchise 35171
permit fee for each intermediate care facility for the mentally 35172
retarded in accordance with section 5112.315166.41 of the Revised 35173
Code.35174

       (B) Not later than the first day of September of each year, 35175
the department shall mail to each intermediate care facility for 35176
the mentally retarded notice of the amount of the franchise permit 35177
fee the facility has been assessed under section 5112.315166.4135178
of the Revised Code.35179

       (C) Each intermediate care facility for the mentally retarded 35180
shall pay its fee under section 5112.315166.41 of the Revised 35181
Code to the department in quarterly installment payments not later 35182
than forty-five days after the last day of each September, 35183
December, March, and June.35184

       Sec. 5112.34.        Sec. 5166.45.  If an intermediate care facility for 35185
the mentally retarded fails to pay the full amount of an 35186
installment when due, the department of job and family services35187
health care administration may assess a five per cent penalty on 35188
the amount due for each month or fraction thereof the installment 35189
is overdue.35190

       Sec. 5112.341.        Sec. 5166.46.  (A) In addition to assessing a 35191
penalty pursuant to section 5112.345166.45 of the Revised Code, 35192
the department of job and family serviceshealth care 35193
administration may do any of the following if an intermediate 35194
care facility for the mentally retarded fails to pay the full 35195
amount of a franchise permit fee installment when due:35196

        (1) Withhold an amount less than or equal to the installment 35197
and penalty assessed under section 5112.345166.45 of the Revised 35198
Code from a medicaid payment due the facility until the facility 35199
pays the installment and penalty;35200

        (2) Offset an amount less than or equal to the installment 35201
and penalty assessed under section 5112.345166.45 of the Revised 35202
Code from a Medicaidmedicaid payment due the nursing facility or 35203
hospital;35204

       (3) Terminate the facility's medicaid provider agreement.35205

        (B) The department may offset a medicaid payment under 35206
division (A) of this section without providing notice to the 35207
intermediate care facility for the mentally retarded and without 35208
conducting an adjudication under Chapter 119. of the Revised 35209
Code.35210

       Sec. 5112.35.        Sec. 5166.47.  (A) An intermediate care facility for 35211
the mentally retarded may appeal the franchise permit fee imposed 35212
under section 5112.315166.41 of the Revised Code solely on the 35213
grounds that the department of job and family serviceshealth care 35214
administration committed a material error in determining the 35215
amount of the fee. A request for an appeal must be received by the 35216
department not later than fifteen days after the date the 35217
department mails the notice of the fee and must include written 35218
materials setting forth the basis for the appeal.35219

       (B) If an intermediate care facility for the mentally35220
retarded submits a request for an appeal within the time required35221
under division (A) of this section, the department shall hold a 35222
public hearing in Columbus not later than thirty days after the 35223
date the department receives the request for an appeal. The 35224
department shall, not later than ten days before the date of the 35225
hearing, mail a notice of the date, time, and place of the hearing 35226
to the facility. The department may hear all requested appeals in 35227
one public hearing.35228

       (C) On the basis of the evidence presented at the hearing or 35229
any other evidence submitted by the intermediate care facility for 35230
the mentally retarded, the department may adjust a fee. The 35231
department's decision is final.35232

       Sec. 5112.37.        Sec. 5166.48.  There is hereby created in the state 35233
treasury the home and community-based services for the mentally 35234
retarded and developmentally disabled fund. Ninety-four and 35235
twenty-eight hundredths per cent of all installment payments and 35236
penalties paid by an intermediate care facility for the mentally 35237
retarded under sections 5112.335166.44 and 5112.345166.45 of35238
the Revised Code shall be deposited into the fund. The 35239
department of job and family serviceshealth care administration35240
shall distribute the money in the fund in accordance with rules 35241
adopted under section 5112.395166.50 of the Revised Code. The 35242
departments of job and family serviceshealth care administration35243
and mental retardation and developmental disabilities shall use 35244
the money for the medicaid program established under Chapter 35245
5111. of the Revised Code and, including home and community-based 35246
services to mentally retarded and developmentally disabled35247
persons with mental retardation or a developmental disability.35248

       Sec. 5112.371.        Sec. 5166.481. There is hereby created in the state 35249
treasury the children with intensive behavioral needs programs 35250
fund. Five and seventy-two hundredths per cent of all installment 35251
payments and penalties paid by an intermediate care facility for 35252
the mentally retarded under sections 5112.335166.44 and 5112.3435253
5166.45 of the Revised Code shall be deposited in the fund. The 35254
money in the fund shall be used for the programs the director of 35255
mental retardation and developmental disabilities establishes 35256
under section 5123.0417 of the Revised Code.35257

       Sec. 5112.38.        Sec. 5166.49.  The department of job and family 35258
serviceshealth care administration may make any investigation it35259
considers appropriate to obtain information necessary to fulfill35260
its duties under sections 5112.305166.40 to 5112.395166.50 of 35261
the Revised Code. At the request of the department, the attorney 35262
general shall aid in any such investigations. The attorney general 35263
shall institute and prosecute all necessary actions for the35264
enforcement of sections 5112.305166.40 to 5112.395166.50 of the 35265
Revised Code, except that at the request of the attorney general, 35266
the county prosecutor of the county in which an intermediate care 35267
facility for the mentally retarded that has failed to comply with 35268
those sections is located shall institute and prosecute any35269
necessary action against the facility.35270

       Sec. 5112.39.        Sec. 5166.50.  The director of job and family35271
serviceshealth care administration shall adopt rules in35272
accordance with Chapter 119. of the Revised Code to do all of the 35273
following:35274

       (A) Establish a composite inflation factor with which to 35275
adjust franchise permit fees under section 5112.315166.41 of the 35276
Revised Code;35277

       (B) Prescribe the actions the department will take to cease 35278
implementation of sections 5112.305166.40 to 5112.395166.50 of 35279
the Revised Code if the United States secretary of health and 35280
human services determines that the franchise permit fee imposed35281
under section 5112.315166.41 of the Revised Code is an 35282
impermissible health care-related tax under section 1903(w) of the 35283
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 1396b(w), 35284
as amended;35285

       (C) Establish the method of distributing the money in the 35286
home and community-based services for the mentally retarded and 35287
developmentally disabled fund created by section 5112.375166.4835288
of the Revised Code;35289

       (D) Establish any other requirements or procedures the35290
director considers necessary to implement sections 5112.305166.4035291
to 5112.395166.50 of the Revised Code.35292

       Sec. 5111.176.        Sec. 5166.60. (A) As used in this section:35293

       (1) "Medicaid health insuring corporation" means a health 35294
insuring corporation that holds a certificate of authority under 35295
Chapter 1751. of the Revised Code and has entered into a contract 35296
with the department of job and family serviceshealth care 35297
administration pursuant to section 5111.175165.05 of the Revised 35298
Code.35299

       (2) "Managed care premium" means any premium payment, 35300
capitation payment, or other payment a medicaid health insuring 35301
corporation receives for providing, or arranging for the provision 35302
of, health care services to its members or enrollees residing in 35303
this state.35304

       (B) Except as provided in division (C) of this section, all 35305
of the following apply:35306

       (1) Each medicaid health insuring corporation shall pay to 35307
the department of job and family serviceshealth care 35308
administration a franchise permit fee for the period December 1, 35309
2005, through December 31, 2005, and each calendar quarter 35310
occurring thereafter.35311

       (2) The fee to be paid is an amount that is equal to a 35312
percentage of the managed care premiums the medicaid health 35313
insuring corporation received in the period December 1, 2005, 35314
through December 31, 2005, and in the subsequent quarter to which 35315
the fee applies, excluding the amount of any managed care premiums 35316
the corporation returned or refunded to enrollees, members, or 35317
premium payers during the period December 1, 2005, through 35318
December 31, 2005, or the subsequent quarter to which the fee 35319
applies.35320

       (3) The percentage to be used in calculating the fee shall be 35321
four and one-half per cent, unless the department adopts rules 35322
under division (L) of this section decreasing the percentage below 35323
four and one-half per cent or increasing the percentage to not 35324
more than six per cent.35325

       (C) The department shall reduce the franchise permit fee 35326
imposed under this section or terminate its collection of the fee 35327
if the department determines either of the following:35328

       (1) That the reduction or termination is required to comply 35329
with federal statutes or regulations;35330

       (2) That the fee does not qualify as a state share of 35331
medicaid expenditures eligible for federal financial 35332
participation.35333

        (D) The franchise permit fee shall be paid on or before the 35334
thirtieth day following the end of the period December 1, 2005, 35335
through December 31, 2005, or the calendar quarter to which the 35336
fee applies. At the time the fee is submitted, the medicaid health 35337
insuring corporation shall file with the department a report on a 35338
form prescribed by the department. The corporation shall provide 35339
on the form all information required by the department and shall 35340
include with the form any necessary supporting documentation.35341

        (E) The department may audit the records of any medicaid 35342
health insuring corporation to determine whether the corporation 35343
is in compliance with this section. The department may audit the 35344
records that pertain to the period December 1, 2005, through 35345
December 31, 2005, or a particular calendar quarter, at any time 35346
during the five years following the date the franchise permit fee 35347
payment for that period or quarter was due.35348

        (F)(1) A medicaid health insuring corporation that does not 35349
pay the franchise permit fee in full by the date the payment is 35350
due is subject to any or all of the following:35351

        (a) A monetary penalty in the amount of five hundred dollars 35352
for each day any part of the fee remains unpaid, except that the 35353
penalty shall not exceed an amount equal to five per cent of the 35354
total fee that was due;35355

        (b) Withholdings from future managed care premiums pursuant 35356
to division (G) of this section;35357

        (c) Termination of the corporation's medicaid provider 35358
agreement pursuant to division (H) of this section.35359

        (2) Penalties imposed under division (F)(1)(a) of this 35360
section are in addition to and not in lieu of the franchise permit 35361
fee.35362

        (G) If a medicaid health insuring corporation fails to pay 35363
the full amount of its franchise permit fee when due, or the full 35364
amount of a penalty imposed under division (F)(1)(a) of this 35365
section, the department may withhold an amount equal to the 35366
remaining amount due from any future managed care premiums to be 35367
paid to the corporation under the medicaid program. The department 35368
may withhold amounts under this division without providing notice 35369
to the corporation. The amounts may be withheld until the amount 35370
due has been paid.35371

        (H) The department may commence actions to terminate a 35372
medicaid health insuring corporation's medicaid provider 35373
agreement, and may terminate the agreement subject to division (I) 35374
of this section, if the corporation does any of the following:35375

        (1) Fails to pay its franchise permit fee or fails to pay the 35376
fee promptly;35377

        (2) Fails to pay a penalty imposed under division (F)(1)(a) 35378
of this section or fails to pay the penalty promptly;35379

        (3) Fails to cooperate with an audit conducted under division 35380
(E) of this section.35381

        (I) At the request of a medicaid health insuring corporation, 35382
the department shall grant the corporation a hearing in accordance 35383
with Chapter 119. of the Revised Code, if either of the following 35384
is the case:35385

        (1) The department has determined that the corporation owes 35386
an additional franchise permit fee or penalty as the result of an 35387
audit conducted under division (E) of this section.35388

        (2) The department is proposing to terminate the 35389
corporation's medicaid provider agreement and the provisions of 35390
section 5111.065163.01 of the Revised Code requiring an 35391
adjudication in accordance with Chapter 119. of the Revised Code 35392
are applicable.35393

       (J)(1) At the request of a medicaid corporation, the 35394
department shall grant the corporation a reconsideration of any 35395
issue that arises out of the provisions of this section and is not 35396
subject to division (I) of this section. The department's decision 35397
at the conclusion of the reconsideration is not subject to appeal 35398
under Chapter 119. of the Revised Code or any other provision of 35399
the Revised Code.35400

        (2) In conducting a reconsideration, the department shall do 35401
at least the following:35402

        (a) Specify the time frames within which a corporation must 35403
act in order to exercise its opportunity for a reconsideration;35404

        (b) Permit the corporation to present written arguments or 35405
other materials that support the corporation's position.35406

        (K) There is hereby created in the state treasury the managed 35407
care assessment fund. Money collected from the franchise permit 35408
fees and penalties imposed under this section shall be credited to 35409
the fund. The department shall use the money in the fund to pay 35410
for medicaid services, the department's administrative costs, and 35411
contracts with medicaid health insuring corporations.35412

        (L) The director of job and family serviceshealth care 35413
administration may adopt rules to implement and administer this 35414
section. The rules shall be adopted in accordance with Chapter 35415
119. of the Revised Code.35416

       Sec. 5112.99.        Sec. 5166.99.  (A) The director of job and family35417
serviceshealth care administration shall impose a penalty for 35418
each day that a hospital fails to report the information required 35419
under section 5112.045166.03 of the Revised Code on or before the 35420
dates specified in that section. The amount of the penalty shall 35421
be established by the director in rules adopted under section 35422
5112.035166.02 of the Revised Code.35423

       (B) In addition to any other remedy available to the35424
department of job and family serviceshealth care administration35425
under law to collect unpaid assessments and transfers, the35426
director shall impose a penalty of ten per cent of the amount due 35427
on any hospital that fails to pay assessments or make35428
intergovernmental transfers by the dates required by rules adopted35429
under section 5112.035166.02 of the Revised Code.35430

       (C) The director shall waive the penalties provided for in35431
divisions (A) and (B) of this section for good cause shown by the35432
hospital.35433

       (D) All penalties imposed under this section shall be35434
deposited into the health care administration fund created by 35435
section 5111.945161.15 of the Revised Code.35436

       Sec. 5167.01. As used in this chapter, "federal poverty 35437
guidelines" has the same meaning as in section 5101.46 of the 35438
Revised Code.35439

       Sec. 5101.50.        Sec. 5167.05.  (A) As used in sections 5101.50 to 35440
5101.529 of the Revised Code:35441

       (1) "Children's health insurance program" means the program 35442
authorized by Title XXI of the "Social Security Act," 111 Stat.35443
552 (1997), 42 U.S.C.A. 1397aa.35444

       (2) "Federal poverty guidelines" has the same meaning as in35445
section 5101.46 of the Revised Code.35446

       (B) The director of job and family serviceshealth care 35447
administration may continue to operate the children's health 35448
insurance program initially authorized by an executive order 35449
issued under section 107.17 of the Revised Code as long as federal 35450
financial participation is available for the program. If operated, 35451
the program shall provide health assistance to uninsured 35452
individuals under nineteen years of age with family incomes not 35453
exceeding one hundred fifty per cent of the federal poverty 35454
guidelines. In accordance with 42 U.S.C.A. 1397aa, the director 35455
may provide for the health assistance to meet the requirements of 35456
42 U.S.C.A. 1397cc, to be provided under the medicaid program 35457
established under Chapter 5111. of the Revised Code, or to be a35458
combination of both.35459

       Sec. 5101.501.        Sec. 5167.06.  Health assistance provided under 35460
section 5101.505167.05 of the Revised Code shall be known as the 35461
children's health insurance program part I.35462

       Sec. 5101.502.        Sec. 5167.07.  The director of job and family 35463
serviceshealth care administration may adopt rules in accordance 35464
with Chapter 119. of the Revised Code as necessary for the 35465
efficient administration of the children's health insurance 35466
program part I, including rules that establish all of the35467
following:35468

       (A) The conditions under which health assistance services 35469
will be reimbursed;35470

       (B) The method of reimbursement applicable to services35471
reimbursable under the program;35472

       (C) The amount of reimbursement, or the method by which the35473
amount is to be determined, for each reimbursable service.35474

       Sec. 5101.503.        Sec. 5167.08.  A completed application for medical 35475
assistance under Chapter 5111. of the Revised Codethe medicaid 35476
program shall be treated as an application for health assistance 35477
under the children's health insurance program part I if the 35478
application is for an assistance group that includes a child under 35479
nineteen years of age and is denied.35480

       Sec. 5101.51.        Sec. 5167.10.  In accordance with federal law 35481
governing the children's health insurance program, the director of 35482
job and family serviceshealth care administration may submit a 35483
state child health plan to the United States secretary of health 35484
and human services to provide, except as provided in section35485
5101.5165167.16 of the Revised Code, health assistance to35486
uninsured individuals under nineteen years of age with family 35487
incomes above one hundred fifty per cent of the federal poverty35488
guidelines but not exceeding two hundred per cent of the federal35489
poverty guidelines. If the director submits the plan, the director 35490
shall include both of the following in the plan:35491

       (A) The health assistance will not begin before January 1, 35492
2000.35493

       (B) The health assistance will be available only while 35494
federal financial participation is available for it. 35495

       Sec. 5101.511.        Sec. 5167.11.  Health assistance provided under 35496
section 5101.515167.10 of the Revised Code shall be known as the 35497
children's health insurance program part II. 35498

       Sec. 5101.512.        Sec. 5167.12.  If the director of job and family 35499
serviceshealth care administration submits a state child health 35500
plan to the United States secretary of health and human services 35501
under section 5101.515167.10 of the Revised Code and the 35502
secretary approves the plan, the director shall implement the35503
children's health insurance program part II in accordance with the35504
plan. The director may adopt rules in accordance with Chapter 119. 35505
of the Revised Code as necessary for the efficient administration 35506
of the program, including rules that establish all of the35507
following:35508

       (A) The conditions under which health assistance services 35509
will be reimbursed;35510

       (B) The method of reimbursement applicable to services35511
reimbursable under the program;35512

       (C) The amount of reimbursement, or the method by which the35513
amount is to be determined, for each reimbursable service.35514

       Sec. 5101.513.        Sec. 5167.13.  The director of job and family 35515
serviceshealth care administration may contract with a government 35516
entity or person to perform the director's administrative duties 35517
regarding the children's health insurance program part II, other 35518
than the duty to submit a state child health plan to the United 35519
States secretary of health and human services under section 35520
5101.515167.10 of the Revised Code and the duty to adopt rules 35521
under section 5101.5125167.12 of the Revised Code.35522

       Sec. 5101.514.        Sec. 5167.14.  In accordance with 42 U.S.C.A.35523
1397aa, the director of health care administration may provide for 35524
health assistance under the children's health insurance program 35525
part II to meet the requirements of 42 U.S.C.A. 1397cc, to be 35526
provided under the medicaid program established under Chapter 35527
5111. of the Revised Code, or to be a combination of both.35528

       Sec. 5101.515.        Sec. 5167.15.  The director of job and family 35529
serviceshealth care administration may determine applicants' 35530
eligibility for the children's health insurance program part II by 35531
any of the following means:35532

       (A) Using employees of the department of job and family35533
serviceshealth care administration;35534

       (B) Assigning the duty to county departments of job and35535
family services;35536

       (C) Contracting with a government entity or person. 35537

       Sec. 5101.516.        Sec. 5167.16.  If the director of job and family 35538
serviceshealth care administration determines that federal 35539
financial participation for the children's health insurance35540
program part II is insufficient to provide health assistance to35541
all the individuals the director anticipates are eligible for the 35542
program, the director may refuse to accept new applications for 35543
the program or may make the program's eligibility requirements 35544
more restrictive.35545

       Sec. 5101.517.        Sec. 5167.17.  To the extent permitted by 42 35546
U.S.C.A. 1397cc(e), the director of job and family serviceshealth 35547
care administration may require an individual receiving health35548
assistance under the children's health insurance program part II 35549
to pay a premium, deductible, coinsurance payment, or other 35550
cost-sharing expense.35551

       Sec. 5101.518.        Sec. 5167.18.  The director of job and family 35552
serviceshealth care administration shall establish an appeal 35553
process for individuals aggrieved by a decision made regarding35554
eligibility for the children's health insurance program part II. 35555
The process may be identical to, similar to, or different from the 35556
appeal process established by section 5101.355160.34 of the 35557
Revised Code.35558

       Sec. 5101.519.        Sec. 5167.19.  A completed application for medical 35559
assistance under Chapter 5111. of the Revised Codethe medicaid 35560
program shall be treated as an application for health assistance 35561
under the children's health insurance program part II if the 35562
application is for an assistance group that includes a child under 35563
nineteen years of age and is denied.35564

       Sec. 5101.52.        Sec. 5167.21.  In accordance with federal law 35565
governing the children's health insurance program, the director 35566
of job and family serviceshealth care administration may submit 35567
a request for a federal waiver to the United States secretary of 35568
health and human services to provide, except as provided in 35569
section 5101.5265167.27 of the Revised Code, health assistance 35570
to individuals under nineteen years of age with family incomes 35571
above two hundred per cent of the federal poverty guidelines but 35572
not exceeding three hundred per cent of the federal poverty 35573
guidelines. If the director submits the plan, the director shall 35574
stipulate in the plan that the health assistance will be 35575
available only while federal financial participation is available 35576
for it and that health assistance shall not begin before January 35577
1, 2008.35578

       Sec. 5101.521.        Sec. 5167.22.  Health assistance provided under 35579
section 5101.525167.21 of the Revised Code shall be known as the 35580
children's health insurance program part III.35581

       Sec. 5101.522.        Sec. 5167.23.  If the director of job and family 35582
serviceshealth care administration submits a waiver request to 35583
the United States secretary of health and human services under 35584
section 5101.525167.21 of the Revised Code and the secretary 35585
grants the waiver, the director shall implement the children's 35586
health insurance program part III in accordance with the waiver. 35587
The director may adopt rules in accordance with Chapter 119. of 35588
the Revised Code as necessary for the efficient administration of 35589
the program, including rules that establish all of the following:35590

       (A) The conditions under which health assistance services 35591
will be reimbursed;35592

       (B) The method of reimbursement applicable to services 35593
reimbursable under the program;35594

       (C) The amount of reimbursement, or the method by which the 35595
amount is to be determined, for each reimbursable service.35596

       Sec. 5101.523.        Sec. 5167.24.  The director of job and family 35597
serviceshealth care administration may contract with a 35598
government entity or person to perform the director's 35599
administrative duties regarding the children's health insurance 35600
program part III, other than the duty to submit a waiver request 35601
to the United States secretary of health and human services under 35602
section 5101.525167.21 of the Revised Code and the duty to adopt 35603
rules under section 5101.5225167.23 of the Revised Code.35604

       Sec. 5101.524.        Sec. 5167.25.  In accordance with 42 U.S.C. 1397aa, 35605
the director of job and family serviceshealth care 35606
administration shall provide for health assistance under the 35607
children's health insurance program part III to meet the 35608
requirements of 42 U.S.C. 1397cc, to be provided under the 35609
medicaid program established under Chapter 5111. of the Revised 35610
Code, or to be a combination of both.35611

       Sec. 5101.525.        Sec. 5167.26.  The director of job and family 35612
serviceshealth care administration may determine applicants' 35613
eligibility for the children's health insurance program part III 35614
by any of the following means:35615

       (A) Using employees of the department of job and family 35616
serviceshealth care administration;35617

       (B) Assigning the duty to county departments of job and 35618
family services;35619

       (C) Contracting with a government entity or person.35620

       Sec. 5101.526.        Sec. 5167.27.  If the director of job and family 35621
serviceshealth care administration determines that federal 35622
financial participation for the children's health insurance 35623
program part III is insufficient to provide health assistance to 35624
all the individuals the director anticipates are eligible for the 35625
program, the director may refuse to accept new applications for 35626
the program or may make the program's eligibility requirements 35627
more restrictive.35628

       Sec. 5101.527.        Sec. 5167.28. To the extent permitted by 42 U.S.C. 35629
1397cc(e), the director of job and family serviceshealth care 35630
administration shall require an individual receiving health 35631
assistance under the children's health insurance program part III 35632
to pay the following as a term of participation in the program:35633

       (A) A premium of not less than forty dollars per month for a 35634
family with one individual receiving health assistance under the 35635
program;35636

       (B) A premium of not less than eighty dollars per month for a 35637
family with two individuals receiving health assistance under the 35638
program;35639

       (C) A premium of not less than one hundred twenty dollars per 35640
month for a family with three or more individuals receiving health 35641
assistance under the program.35642

       Sec. 5101.528.        Sec. 5167.29.  If the children's health insurance 35643
program part III is not provided under the medicaid program 35644
established under Chapter 5111. of the Revised Code, the director 35645
of job and family serviceshealth care administration shall 35646
establish an appeal process for individuals aggrieved by a 35647
decision made regarding eligibility for the children's health 35648
insurance program part III. The process may be identical to, 35649
similar to, or different from the appeal process established by 35650
section 5101.355160.34 of the Revised Code.35651

       Sec. 5101.529.        Sec. 5167.30.  A completed application for the 35652
medicaid program under Chapter 5111. of the Revised Code shall be 35653
treated as an application for health assistance under the 35654
children's health insurance program part III.35655

       Sec. 5101.5110.        Sec. 5167.32.  (A) The director of job and family35656
serviceshealth care administration may submit a waiver request to 35657
the United States secretary of health and human services to 35658
provide health assistance to any individual who meets all of the 35659
following requirements:35660

       (1) Is the parent of a child under nineteen years of age who35661
resides with the parent and is eligible for health assistance35662
under the children's health insurance program part I or II or the35663
medicaid program established under Chapter 5111. of the Revised35664
Code;35665

       (2) Is uninsured;35666

       (3) Has a family income that does not exceed one hundred per35667
cent of the federal poverty guidelines.35668

       (B) A waiver request the director submits under division (A)35669
of this section may seek federal funds allotted to the state under35670
Title XXI of the "Social Security Act," 111 Stat. 558 (1997), 4235671
U.S.C.A. 1397dd, as amended, that are not otherwise used to fund35672
the children's health insurance program parts I and II.35673

       (C) If a waiver request the director submits under division35674
(A) of this section is granted, the director may adopt rules in35675
accordance with Chapter 119. of the Revised Code as necessary for35676
the efficient administration of the program authorization by the35677
waiver.35678

       Sec. 5101.5211.        Sec. 5167.35.  (A) As used in sections 5101.521135679
5167.35 to 5101.52165167.40 of the Revised Code:35680

       "Children's buy-in program" means the program established 35681
under sections 5101.5211 to 5101.5216 of the Revised Code.35682

       "Countable family income" has the meaning established in 35683
rules adopted under section 5101.52155167.39 of the Revised 35684
Code.35685

       "Creditable coverage" has the same meaning as in 42 U.S.C. 35686
300gg(c)(1), except that it does not mean medical assistance 35687
available under the children's buy-in program or the program for 35688
medically handicapped children.35689

       "Family" has the meaning established in rules adopted under 35690
section 5101.52155167.39 of the Revised Code.35691

       "Federal poverty guidelines" has the same meaning as in 35692
section 5101.46 of the Revised Code.35693

       "Program for medically handicapped children" means the 35694
program established under sections 3701.021 to 3701.0210 of the 35695
Revised Code.35696

       (B) The director of job and family serviceshealth care 35697
administration shall establish the children's buy-in program in 35698
accordance with sections 5101.52115167.35 to 5101.52165167.4035699
of the Revised Code. The director shall submit to the United 35700
States secretary of health and human services an amendment to 35701
the state medicaid plan, an amendment to the state child health 35702
plan, one or more requests for a federal waiver, or such an 35703
amendment and waiver requests as necessary to seek federal 35704
matching funds for the children's buy-in program. The director 35705
shall not begin implementation of the program until after 35706
submitting the amendment, waiver request, or both. The director 35707
may begin implementation of the program before receiving approval 35708
of the amendment, waiver request, or both using state funds only. 35709
The director shall implement the program regardless of whether 35710
the amendment, waiver request, or both are denied. The program 35711
shall be funded with state funds only if the United States 35712
secretary denies federal matching funds for the program. If the 35713
United States secretary approves federal matching funds for the 35714
program and if permitted under the terms of the approval, the 35715
program shall be operated as part of the medicaid program, the 35716
children's health insurance program, or both.35717

       Sec. 5101.5212.        Sec. 5167.36.  Under the children's buy-in program 35718
and subject to section 5101.52135167.37 of the Revised Code, an 35719
individual who does both of the following in accordance with 35720
rules adopted under section 5101.52155167.39 of the Revised 35721
Code qualifies for medical assistance under the program, unless 35722
the director of job and family serviceshealth care 35723
administration has adopted rules under division (B) of section 35724
5101.52155167.39 of the Revised Code to limit the number of 35725
individuals who may participate in the program at one time and the 35726
program is serving the maximum number of individuals specified in 35727
the rules:35728

       (A) Applies for the children's buy-in program;35729

       (B) Provides satisfactory evidence of all of the following:35730

       (1) That the individual is under nineteen years of age;35731

       (2) That the individual's countable family income exceeds 35732
two hundred fifty per cent of the federal poverty guidelines;35733

       (3) That the individual has not had creditable coverage for 35734
at least six months before enrolling in the children's buy-in 35735
program, unless the individual lost the only creditable coverage 35736
available to the individual because the individual exhausted a 35737
lifetime benefit limitation;35738

       (4) That one or more of the following apply to the 35739
individual:35740

       (a) The individual is unable to obtain creditable coverage 35741
due to a pre-existing condition of the individual;35742

       (b) The individual lost the only creditable coverage 35743
available to the individual because the individual has exhausted 35744
a lifetime benefit limitation;35745

       (c) The premium for the only creditable coverage available to 35746
the individual is greater than two hundred per cent of the premium 35747
applicable to the individual under the children's buy-in program;35748

       (d) The individual participates in the program for medically 35749
handicapped children.35750

       (5) That the individual meets the additional eligibility 35751
requirements for the children's buy-in program established in 35752
rules adopted under section 5101.52155167.39 of the Revised 35753
Code.35754

       Sec. 5101.5213.        Sec. 5167.37.  (A) An individual participating in 35755
the children's buy-in program shall be charged a monthly 35756
premium established by rules adopted under section 5101.521535757
5167.39 of the Revised Code. The amount of the monthly premium 35758
shall not be less than the following:35759

       (1) In the case of an individual with countable family income 35760
exceeding two hundred fifty per cent but not exceeding four 35761
hundred per cent of the federal poverty guidelines, the 35762
following amount:35763

       (a) If no other member of the individual's family receives 35764
medical assistance under the program with the individual, one 35765
hundred dollars;35766

       (b) If one or more members of the individual's family receive 35767
medical assistance under the program with the individual, one 35768
hundred fifty dollars.35769

       (2) In the case of an individual with countable family income 35770
exceeding four hundred per cent but not exceeding five hundred 35771
per cent of the federal poverty guidelines, the following 35772
amount:35773

       (a) If no other member of the individual's family receives 35774
medical assistance under the program with the individual, one 35775
hundred twenty-five dollars;35776

       (b) If one or more members of the individual's family receive 35777
medical assistance under the program with the individual, one 35778
hundred seventy-five dollars.35779

       (3) In the case of an individual with countable family 35780
income exceeding five hundred per cent of the federal poverty 35781
guidelines, the full amount of the actuarially determined cost 35782
of the premium.35783

       (B) If the premium for the children's buy-in program is not 35784
paid for two consecutive months, the individual shall lose 35785
eligibility for the program. The individual may not resume 35786
participation in the program until the unpaid premiums that 35787
accrued before the individual lost eligibility are paid.35788

       Sec. 5101.5214.        Sec. 5167.38.  (A) An individual participating in 35789
the children's buy-in program shall be charged co-payments 35790
established by rules adopted under section 5101.52155167.39 of 35791
the Revised Code.35792

       (B) Notwithstanding division (B) of section 5111.01125162.3535793
of the Revised Code, if applicable, and to the extent permitted 35794
by federal law, a provider may refuse to provide a service to an 35795
individual if a co-payment required by this section is not 35796
paid.35797

       Sec. 5101.5215.        Sec. 5167.39. (A) The director of job and family 35798
serviceshealth care administration shall adopt rules in 35799
accordance with Chapter 119. of the Revised Code as necessary to 35800
implement the children's buy-in program, including rules that do 35801
all of the following:35802

       (1) Establish the meaning of "countable family income" and 35803
"family";35804

       (2) For the purpose of section 5101.52125167.36 of the 35805
Revised Code, establish additional eligibility requirements for 35806
the program;35807

       (3) For the purpose of section 5101.52135167.37 of the 35808
Revised Code, establish monthly premiums for the children's 35809
buy-in program;35810

       (4) For the purpose of section 5101.52145167.38 of the 35811
Revised Code, establish copayment requirements for the children's 35812
buy-in program.35813

       (B) The director may adopt rules in accordance with Chapter 35814
119. of the Revised Code to limit the number of individuals who 35815
may participate in the children's buy-in program at one time.35816

       Sec. 5101.5216.        Sec. 5167.40. The director of job and family 35817
serviceshealth care administration shall prepare a report on the 35818
children's buy-in program that examines the program's 35819
effectiveness and includes the number of individuals 35820
participating in the program and the costs of the program. The 35821
director shall submit the report to the governor and general 35822
assembly not later than December 31, 2008.35823

       Sec. 5115.10.        Sec. 5168.01.  (A) The director of job and family 35824
serviceshealth care administration shall establish a disability 35825
medical assistance program. 35826

        (B) Subject to all other eligibility requirements established 35827
by this chapter and the rules adopted under it for the disability 35828
medical assistance program, a person may be eligible for 35829
disability medical assistance only if the person is medication 35830
dependent, as determined by the department of job and family 35831
serviceshealth care administration.35832

        (C) The director shall adopt rules under section 111.15 of 35833
the Revised Code for purposes of implementing division (B) of this 35834
section. The rules may specify or establish any or all of the 35835
following:35836

       (1) Standards for determining whether a person is medication 35837
dependent, including standards under which a person may qualify as 35838
being medication dependent only if it is determined that both of 35839
the following are the case:35840

        (a) The person is receiving ongoing treatment for a chronic 35841
medical condition that requires continuous prescription medication 35842
for an indefinite, long-term period of time;35843

       (b) Loss of the medication would result in a significant risk 35844
of medical emergency and loss of employability lasting at least 35845
nine months.35846

        (2) A requirement that a person's medical condition be 35847
certified by an individual authorized under Chapter 4731. of the 35848
Revised Code to practice medicine and surgery or osteopathic 35849
medicine and surgery;35850

       (3) Limitations on the chronic medical conditions and 35851
prescription medications that may qualify a person as being 35852
medication dependent.35853

       Sec. 5115.11.        Sec. 5168.02.  An individual who qualifies for the 35854
medical assistancemedicaid program established under Chapter 35855
5111. of the Revised Code shall receive medical assistance through 35856
that program rather than through the disability medical assistance 35857
program.35858

       An individual is ineligible for disability medical assistance 35859
if, for the purpose of avoiding consideration of property in35860
determinations of the individual's eligibility for disability 35861
medical assistance or a greater amount of assistance, the person 35862
has transferred property during the two years preceding 35863
application for or most recent redetermination of eligibility for 35864
disability medical assistance.35865

       Sec. 5168.03.  Each applicant for or recipient of disability 35866
medical assistance who, in the judgment of the department of 35867
health care administration or a county department of job and 35868
family services might be eligible for benefits under the 35869
supplemental security program, shall, as a condition of 35870
eligibility for assistance, apply for such benefits if directed to 35871
do so by the department or county department.35872

       Sec. 5168.04.  As a condition of eligibility for disability 35873
medical assistance, and as a means of preventing or reducing the 35874
provision of assistance at public expense, each applicant for or 35875
recipient of the assistance shall make reasonable efforts to 35876
secure support from persons responsible for the applicant's or 35877
recipient's support, and from other sources, including any federal 35878
program designed to provide assistance to individuals with 35879
disabilities. The department of health care administration or 35880
county department of job and family services may provide 35881
assistance to the applicant or recipient in securing other forms 35882
of assistance.35883

       Sec. 5115.12.        Sec. 5168.05. (A) The director of job and family 35884
serviceshealth care administration shall adopt rules in 35885
accordance with section 111.15 of the Revised Code governing the 35886
disability medical assistance program. The rules may establish or 35887
specify any or all of the following:35888

       (1) Income, resource, citizenship, age, residence, living 35889
arrangement, and other eligibility requirements;35890

        (2) Health services to be included in the program;35891

        (3) The maximum authorized amount, scope, duration, or limit 35892
of payment for services;35893

        (4) Limits on the length of time an individual may receive 35894
disability medical assistance;35895

        (5) Limits on the total number of individuals in the state 35896
who may receive disability medical assistance;35897

       (6) Limits on the number and types of providers eligible to 35898
be reimbursed for services provided to individuals enrolled in the 35899
program.35900

        (B) For purposes of limiting the cost of the disability 35901
medical assistance program, the director may do either of the 35902
following:35903

       (1) Adopt rules in accordance with section 111.15 of the 35904
Revised Code that revise the program's eligibility requirements; 35905
the maximum authorized amount, scope, duration, or limit of 35906
payment for services included in the program; or any other 35907
requirement or standard established or specified by rules adopted 35908
under division (A) of this section or under section 5115.1035909
5168.01 of the Revised Code;35910

       (2) Suspend acceptance of applications for disability medical 35911
assistance. While a suspension is in effect, no person shall 35912
receive a determination or redetermination of eligibility for 35913
disability medical assistance unless the person was receiving the 35914
assistance during the month immediately preceding the suspension's 35915
effective date or the person submitted an application prior to the 35916
suspension's effective date and receives a determination of 35917
eligibility based on that application. The director may adopt 35918
rules in accordance with section 111.15 of the Revised Code 35919
establishing requirements and specifying procedures applicable to 35920
the suspension of acceptance of applications.35921

       Sec. 5115.14.        Sec. 5168.06. (A) The director of job and family 35922
serviceshealth care administration shall adopt rules in 35923
accordance with section 111.15 of the Revised Code establishing 35924
application and verification procedures, reapplication procedures, 35925
and other requirements the director considers necessary in the 35926
administration of the application process for disability medical 35927
assistance.35928

       (B) Any person who applies for disability medical assistance 35929
shall receive a voter registration application under section 35930
3503.10 of the Revised Code.35931

       Sec. 5115.13.        Sec. 5168.07.  (A) The department of job and family 35932
serviceshealth care administration shall supervise and administer 35933
the disability medical program, except as follows:35934

       (1) The department may require county departments of job and 35935
family services to perform any administrative function specified 35936
in rules adopted by the director of job and family serviceshealth 35937
care administration.35938

        (2) The director may contract with any private or public 35939
entity in this state to perform any administrative function or to 35940
administer any or all of the program.35941

        (B) If the department requires county departments to perform 35942
administrative functions, the director of job and family services35943
health care administration shall adopt rules in accordance with 35944
section 111.15 of the Revised Code governing the performance of 35945
the functions to be performed by county departments. County 35946
departments shall perform the functions in accordance with the 35947
rules.35948

        If the director contracts with a private or public entity to 35949
perform administrative functions or to administer any or all of 35950
the program, the director may either adopt rules in accordance 35951
with section 111.15 of the Revised Code or include provisions in 35952
the contract governing the performance of the functions by the 35953
private or public entity. Entities under contract shall perform 35954
the functions in accordance with the requirements established by 35955
the director.35956

       (C) Whenever division (A)(1) or (2) of this section is 35957
implemented, the director shall conduct investigations to 35958
determine whether disability medical assistance is being 35959
administered in compliance with the Revised Code and rules adopted 35960
by the director or in accordance with the terms of the contract.35961

       Sec. 5168.08.  If a recipient of disability medical 35962
assistance, or an individual whose income and resources are 35963
included in determining the recipient's eligibility for the 35964
assistance, becomes possessed of resources or income in excess of 35965
the amount allowed to retain eligibility, or if other changes 35966
occur that affect the recipient's eligibility or need for 35967
assistance, the recipient shall notify the department of health 35968
care administration or county department of job and family 35969
services within the time limits specified in rules adopted by the 35970
director of health care administration in accordance with section 35971
111.15 of the Revised Code. Failure of a recipient to report 35972
possession of excess resources or income or a change affecting 35973
eligibility or need within those time limits shall be considered 35974
prima-facie evidence of intent to defraud under section 5168.09 of 35975
the Revised Code.35976

       Sec. 5168.09.  As used in this section, "erroneous payments" 35977
means disability medical assistance payments made to persons who 35978
are not entitled to receive them, including payments made as a 35979
result of misrepresentation or fraud, and payments made due to an 35980
error by the recipient or by the county department of job and 35981
family services that made the payment.35982

       The department of health care administration shall adopt 35983
rules in accordance with section 111.15 of the Revised Code 35984
specifying the circumstances under which action is to be taken 35985
under this section to recover erroneous payments. The department, 35986
or a county department of job and family services at the request 35987
of the department, shall take action to recover erroneous payments 35988
in the circumstances specified in the rules. The department or 35989
county department may institute a civil action to recover 35990
erroneous payments.35991

       Each county department of job and family services shall 35992
retain fifty per cent of the erroneous payments it recovers under 35993
this section. The department of health care administration shall 35994
receive the remaining fifty per cent.35995

       Sec. 5168.10. Whenever disability medical assistance has been 35996
furnished to a recipient for whose support another person is 35997
responsible, the other person shall, in addition to the liability 35998
otherwise imposed, as a consequence of failure to support the 35999
recipient, be liable for all assistance furnished the recipient. 36000
The value of the assistance so furnished may be recovered in a 36001
civil action brought by the county department of job and family 36002
services.36003

       Sec. 173.71.        Sec. 5169.01.  As used in sections 173.71 to 173.91 of 36004
the Revised Codethis chapter:36005

       (A) "Children's health insurance program" means the 36006
children's health insurance program part I, part II, and part III 36007
established under sections 5101.50 to 5101.529 of the Revised 36008
Code.36009

       (B) "Disability medical assistance program" means the program 36010
established under section 5115.10 of the Revised Code.36011

       (C) "Medicaid program" or "medicaid" means the medical 36012
assistance program established under Chapter 5111. of the Revised 36013
Code.36014

       (D) "National drug code number" means the number registered 36015
for a drug pursuant to the listing system established by the 36016
United States food and drug administration under the "Drug Listing 36017
Act of 1972," 86 Stat. 559, 21 U.S.C. 360, as amended.36018

       (E)(B) "Ohio's best Rx program participant" or "participant" 36019
means an individual determined eligible for the Ohio's best Rx 36020
program and included under an Ohio's best Rx program enrollment 36021
card.36022

       (F)(C) "Participating manufacturer" means a drug manufacturer 36023
participating in the Ohio's best Rx program pursuant to a 36024
manufacturer agreement entered into under section 173.81 of the 36025
Revised Code.36026

       (G)(D) "Participating terminal distributor" means a terminal 36027
distributor of dangerous drugs participating in the Ohio's best Rx 36028
program pursuant to an agreement entered into under section 173.79 36029
of the Revised Code.36030

       (H)(E) "Political subdivision" has the same meaning as in 36031
section 9.23 of the Revised Code.36032

       (I)(F) "State agency" has the same meaning as in section 9.23 36033
of the Revised Code.36034

       (J)(G) "Terminal distributor of dangerous drugs" has the same 36035
meaning as in section 4729.01 of the Revised Code.36036

       (K)(H) "Third-party payer" has the same meaning as in section 36037
3901.38 of the Revised Code.36038

       (L)(I) "Trade secret" has the same meaning as in section 36039
1333.61 of the Revised Code.36040

       (M)(J) "Usual and customary charge" means the amount a 36041
participating terminal distributor or the drug mail order system 36042
included in the Ohio's best Rx program pursuant to section 173.78 36043
of the Revised Code charges when a drug included in the program is 36044
purchased by an individual who does not receive a discounted price 36045
for the drug pursuant to any drug discount program, including the 36046
Ohio's best Rx program or a pharmacy assistance program 36047
established by any person or government entity, and for whom no 36048
third-party payer or program funded in whole or part with state or 36049
federal funds is responsible for all or part of the cost of the 36050
drug.36051

       Sec. 173.72.        Sec. 5169.02. There is hereby established the Ohio's 36052
best Rx program for the purpose of providing outpatient 36053
prescription drug discounts to individuals residing in this state 36054
who are enrolled in the program by meeting the eligibility 36055
requirements specified in section 173.765169.06 of the Revised 36056
Code, including eligible individuals who are sixty years of age or 36057
older, eligible individuals who have low incomes but are not 36058
eligible for medicaid, and other eligible individuals who do not 36059
have health benefits that cover outpatient drugs. The program 36060
shall include all drugs that are included in a manufacturer 36061
agreement entered into under section 173.815169.11 of the Revised 36062
Code and all other drugs that may be dispensed only pursuant to a 36063
prescription issued by a licensed health professional authorized 36064
to prescribe drugs, as defined in section 4729.01 of the Revised 36065
Code.36066

       Sec. 173.721.        Sec. 5169.021. (A) Except as provided in division (B) 36067
of this section, the Ohio's best Rx program shall be administered 36068
by the department of aginghealth care administration.36069

       (B)(1) The department may enter into a contract with any 36070
person under which the person serves as the administrator of the 36071
Ohio's best Rx program. Before entering into a contract for a 36072
program administrator, the department shall issue a request for 36073
proposals from persons seeking to be considered. The department 36074
shall develop a process to be used in issuing the request for 36075
proposals, receiving responses to the request, and evaluating the 36076
responses on a competitive basis. In accordance with that process, 36077
the department shall select the person to be awarded the contract.36078

       (2) Subject to divisions (B)(5) and (6) of this section, the 36079
department may delegate to the person awarded the contract any of 36080
the department's powers or duties specified in sections 173.7136081
5169.01 to 173.915169.21 of the Revised Code or any other 36082
provision of the Revised Code pertaining to the Ohio's best Rx 36083
program. The terms of the contract shall specify the extent to 36084
which the powers or duties are delegated to the program 36085
administrator.36086

        (3) In exercising powers or performing duties delegated under 36087
the contract, the program administrator is subject to the same 36088
provisions of sections 173.715169.01 to 173.915169.21 of the 36089
Revised Code or other provisions of the Revised Code that grant 36090
the powers or duties to the department, as well as any limitations 36091
or restrictions that are applicable to or associated with those 36092
powers or duties.36093

       (4) Wherever the department is referred to in sections 173.7136094
5169.01 to 173.915169.21 of the Revised Code or another provision 36095
of the Revised Code relative to a power or duty delegated to the 36096
program administrator, both of the following apply:36097

        (a) If the department has delegated the power or duty in 36098
whole to the program administrator, the reference to the 36099
department is, instead, a reference to the administrator.36100

        (b) If the department retains any part of the power or duty 36101
that is delegated to the program administrator, the reference to 36102
the department is a reference to both the department and the 36103
administrator.36104

        (5) The terms of a contract for a program administrator shall 36105
include provisions for offering the drug mail order system 36106
included in the Ohio's best Rx program pursuant to section 173.7836107
5169.08 of the Revised Code. The terms of the contract may permit 36108
the administrator to offer the drug mail order system by 36109
contracting with another person.36110

        (6) The department shall not delegate to a program 36111
administrator the department's powers or duties to do any of the 36112
following:36113

        (a) Enter into contracts under this section other than a 36114
contract to offer a drug mail order system;36115

        (b) Receive verification of drug pricing information under 36116
section 173.7425169.042 of the Revised Code or verification of 36117
drug manufacturer payment information under section 173.81436118
5169.114 of the Revised Code from the pharmacy benefit manager 36119
selected under section 173.7315169.031 of the Revised Code to 36120
serve as the Ohio's best Rx program's consulting pharmacy benefit 36121
manager;36122

       (c) Request the program's consulting pharmacy benefit manager 36123
to provide for an audit under section 173.7325169.032 of the 36124
Revised Code;36125

       (d) Review or use any information contained in or pertaining 36126
to an audit provided for by the program's consulting pharmacy 36127
benefit manager other than the audit's findings of whether the 36128
consulting pharmacy benefit manager provided valid information 36129
when providing drug pricing verification services or drug 36130
manufacturer payment verification services;36131

       (e) Adopt rules under section 173.835169.13 or 173.8436132
5169.14 of the Revised Code;36133

        (f) Employ an ombudsperson pursuant to section 173.72336134
5169.023 of the Revised Code.36135

       Sec. 173.722.        Sec. 5169.022.  The department of aginghealth care 36136
administration shall undertake outreach efforts to publicize the 36137
Ohio's best Rx program and maximize participation in the program.36138

       Sec. 173.723.        Sec. 5169.023. The department of aginghealth care 36139
administration shall employ an ombudsperson to assist terminal 36140
distributors of dangerous drugs with grievances regarding the 36141
Ohio's best Rx program.36142

       Sec. 173.724.        Sec. 5169.024.  The department of aginghealth care 36143
administration may coordinate the Ohio's best Rx program with 36144
either of the following:36145

       (A) TheIn cooperation with the department of aging, the36146
golden buckeye card program established under section 173.06 of 36147
the Revised Code. In coordinating the programs, the department36148
departments may establish a card that serves as both a golden 36149
buckeye card provided under section 173.06 of the Revised Code and 36150
an Ohio's best Rx program enrollment card issued under section 36151
173.7735169.073 of the Revised Code. The departmentdepartments36152
may identify the card by including the names of both programs on 36153
the card or by selecting a combined name for inclusion on the 36154
card.36155

       (B) Any health benefit plan offered to the employees of state 36156
agencies and the eligible dependents of those employees, for 36157
purposes of enhancing efficiency, reducing the cost of drugs, and 36158
maximizing the benefits of the Ohio's best Rx program and the 36159
health benefit plan.36160

       Sec. 173.73.        Sec. 5169.03. (A) Any entity that provides services as 36161
a pharmacy benefit manager relative to the outpatient drug 36162
coverage included in a health benefit plan offered to the 36163
employees or retirees of a state agency or political subdivision 36164
and the eligible dependents of those employees or retirees shall 36165
provide drug pricing verification services under section 173.74236166
5169.042 of the Revised Code and drug manufacturer payment 36167
verification services under section 173.8145169.114 of the 36168
Revised Code if the entity is selected under section 173.73136169
5169.031 of the Revised Code by the department of aginghealth 36170
care administration to serve as the Ohio's best Rx program's 36171
consulting pharmacy benefit manager for purposes of providing the 36172
verification services.36173

       (B) Both of the following apply to the entity selected to 36174
serve as the Ohio's best Rx program's consulting pharmacy benefit 36175
manager:36176

       (1) The entity shall provide the drug pricing verification 36177
services and drug manufacturer payment verification services 36178
without charge, either to the Ohio's best Rx program or to the 36179
state agency or political subdivision for which it provides 36180
services as a pharmacy benefit manager.36181

       (2) The entity shall provide the verification services for 36182
the entire year for which it is selected to serve as the program's 36183
consulting pharmacy benefit manager, regardless of the duration or 36184
termination of its responsibility to the state agency or political 36185
subdivision for which it provides services as a pharmacy benefit 36186
manager.36187

       (C) If the entity selected to serve as the consulting 36188
pharmacy benefit manager fails to provide the program with drug 36189
pricing verification services or drug manufacturer payment 36190
verification services, or fails to provide for an audit when 36191
requested to do so under section 173.7325169.032 of the Revised 36192
Code, the department may ask the attorney general to bring an 36193
action for injunctive relief in any court of competent 36194
jurisdiction. On the filing of an appropriate petition in the 36195
court, the court shall conduct a hearing on the petition. If it is 36196
demonstrated in the proceedings that the pharmacy benefit manager 36197
has failed to provide the verification services or has failed to 36198
provide for the audit, the court shall grant a temporary or 36199
permanent injunction enjoining the pharmacy benefit manager from 36200
continuing to fail to provide the verification services or from 36201
continuing to fail to provide for the audit.36202

       (D) This section does not impose any duty on the state agency 36203
or political subdivision for which an entity provides services as 36204
a pharmacy benefit manager.36205

       Sec. 173.731.        Sec. 5169.031. Annually, the department of aging36206
health care administration shall select a pharmacy benefit 36207
manager, from among the pharmacy benefit managers subject to 36208
section 173.735169.03 of the Revised Code, to serve as the Ohio's 36209
best Rx program's consulting pharmacy benefit manager for purposes 36210
of providing drug pricing verification services under section 36211
173.7425169.042 of the Revised Code and drug manufacturer payment 36212
verification services under section 173.8145169.114 of the 36213
Revised Code. The department shall select the pharmacy benefit 36214
manager that the department considers to be the most appropriate 36215
pharmacy benefit manager to provide the verification services for 36216
the Ohio's best Rx program. In making the selection, the 36217
department shall consider the pharmacy benefit manager that 36218
provides services relative to the outpatient drug coverage 36219
included in the health benefit plan offered to the greatest number 36220
of employees or retirees of a state agency or political 36221
subdivision and the eligible dependents of those employees or 36222
retirees.36223

       The department shall provide written notice to the pharmacy 36224
benefit manager that it has been selected to serve as the Ohio's 36225
best Rx program's consulting pharmacy benefit manager. The notice 36226
shall specify the date on which the pharmacy benefit manager is to 36227
begin serving as the program's consulting pharmacy benefit manager 36228
for the ensuing year.36229

       Before the end of the one-year period during which a pharmacy 36230
benefit manager is to serve as the program's consulting pharmacy 36231
benefit manager, the department shall make another selection in 36232
accordance with this section. In making the selection, the 36233
department may select the same pharmacy benefit manager to serve 36234
as the program's consulting pharmacy benefit manager or may select 36235
another pharmacy benefit manager.36236

       Sec. 173.732.        Sec. 5169.032. (A) To determine whether the pharmacy 36237
benefit manager selected under section 173.7315169.031 of the 36238
Revised Code to serve as the Ohio's best Rx program's consulting 36239
pharmacy benefit manager has provided valid information when 36240
providing drug pricing verification services under section 173.74236241
5169.042 of the Revised Code or drug manufacturer payment 36242
verification services under section 173.8145169.114 of the 36243
Revised Code, the department of aginghealth care administration36244
may request that the consulting pharmacy benefit manager provide 36245
for an audit of its relevant contracts with drug manufacturers and 36246
terminal distributors of dangerous drugs.36247

       In making audit requests under this section, both of the 36248
following apply:36249

       (1) The department may request an audit on a regularly 36250
occurring basis, but not more frequently than once every three 36251
years.36252

       (2) The department may request an audit at any time it has a 36253
reasonable basis to believe that the consulting pharmacy benefit 36254
manager is not acting in good faith in providing drug pricing 36255
verification services or drug manufacturer payment verification 36256
services. Notice of the request shall be made in writing and 36257
signed by the director of aginghealth care administration. The 36258
notice may specify the basis for the belief that the consulting 36259
pharmacy benefit manager is not acting in good faith. If the basis 36260
for the belief is not specified and the audit findings demonstrate 36261
that the consulting pharmacy benefit manager acted in good faith, 36262
the department shall pay the cost incurred by the consulting 36263
pharmacy benefit manager in providing for the audit.36264

       (B) An audit provided for under this section shall be 36265
performed only by an auditor that is mutually satisfactory to the 36266
department and consulting pharmacy benefit manager and independent 36267
of both the department and consulting pharmacy benefit manager.36268

       (C) If the findings of an audit provided for under this 36269
section demonstrate that the verification services provided by the 36270
consulting pharmacy benefit manager did not result in valid 36271
information, the department shall use the audit findings for 36272
purposes of confirming the validity of the one or more drug 36273
pricing formulas designated under section 173.7415169.041 of the 36274
Revised Code and entering into agreements with drug manufacturers 36275
under section 173.815169.11 of the Revised Code.36276

       Sec. 173.74.        Sec. 5169.04. Annually, the department of aginghealth 36277
care administration shall establish a base price for each drug 36278
included in the Ohio's best Rx program. In the case of drugs 36279
dispensed by a terminal distributor of dangerous drugs that has 36280
entered into an agreement under section 173.795169.09 of the 36281
Revised Code, the base price shall be established by using the one 36282
or more formulas designated under section 173.7415169.041 of the 36283
Revised Code. In the case of the drug mail order system included 36284
in the program pursuant to section 173.785169.08 of the Revised 36285
Code, the base price shall be established in accordance with the 36286
rules adopted under section 173.835169.13 of the Revised Code 36287
governing the drug mail order system.36288

       Sec. 173.741.        Sec. 5169.041. Annually, the department of aging36289
health care administration shall designate one or more formulas 36290
for use in establishing under section 173.745169.04 of the 36291
Revised Code the Ohio's best Rx program's base price for drugs 36292
dispensed by a terminal distributor of dangerous drugs that has 36293
entered into an agreement under section 173.795169.09 of the 36294
Revised Code. Each formula shall include a drug pricing discount 36295
component that is expressed as a percentage discount. The formula 36296
used for generic drugs may include the maximum allowable cost 36297
limits that apply to generic drugs under the medicaid program.36298

       In designating the one or more formulas, the department shall 36299
use the best information on drug pricing that is available to the 36300
department, including information obtained through the drug 36301
pricing verification services provided under section 173.74236302
5169.042 of the Revised Code by the Ohio's best Rx program's 36303
consulting pharmacy benefit manager selected under section 173.73136304
5169.031 of the Revised Code. Based on the available information, 36305
the department shall modify the one or more formulas as it 36306
considers appropriate to maximize the benefits provided to Ohio's 36307
best Rx program participants.36308

       Sec. 173.742.        Sec. 5169.042. For purposes of section 173.74136309
5169.041 of the Revised Code, the department of aginghealth care 36310
administration shall obtain verification of drug pricing 36311
information from the Ohio's best Rx program's consulting pharmacy 36312
benefit manager selected under section 173.7315169.031 of the 36313
Revised Code. The information shall be obtained in accordance with 36314
the following procedures:36315

       (A) For brand name drugs, excluding generic drugs marketed 36316
under brand names, the department shall submit to the consulting 36317
pharmacy benefit manager the formula the department proposes to 36318
use to establish the program's base price for brand name drugs 36319
during the year.36320

       The consulting pharmacy benefit manager shall review the 36321
formula submitted by the department. In conducting the review, the 36322
consulting pharmacy benefit manager shall compare the drug pricing 36323
discount percentage included in the department's formula to the 36324
drug pricing discount percentage included in the formula most 36325
commonly used by the consulting pharmacy benefit manager to 36326
establish part of its payment rate for brand name drugs dispensed 36327
by terminal distributors of dangerous drugs other than drug mail 36328
order systems. If the formulas are not expressed in equivalent 36329
terms, the consulting pharmacy benefit manager shall make all 36330
accommodations necessary to make the comparison of the discount 36331
percentages.36332

       After conducting the review, the consulting pharmacy benefit 36333
manager shall provide information to the department verifying 36334
whether the discount percentage included in the department's 36335
formula is more than two percentage points below the discount 36336
percentage included in the formula used by the consulting pharmacy 36337
benefit manager. The information provided to the department shall 36338
be certified by signature of an officer of the consulting pharmacy 36339
benefit manager.36340

       (B) For generic drugs, the department shall identify the 36341
fifty generic drugs most frequently purchased by Ohio's best Rx 36342
program participants in the immediately preceding year from 36343
terminal distributors of dangerous drugs other than the drug mail 36344
order system included in the program pursuant to section 173.7836345
5169.08 of the Revised Code. The department shall submit to the 36346
consulting pharmacy benefit manager the names of the fifty drugs, 36347
the number of prescriptions filled for each of the drugs, the 36348
formula used to compute the base price for the drugs during the 36349
year, and the weighted average base price for the drugs that 36350
resulted for the year.36351

       The consulting pharmacy benefit manager shall review the 36352
submitted information. In conducting the review, the consulting 36353
pharmacy benefit manager shall compare the department's weighted 36354
average base price to the equivalent part of the consulting 36355
pharmacy benefit manager's weighted average payment rate for the 36356
same drugs when dispensed by terminal distributors of dangerous 36357
drugs other than drug mail order systems. For purposes of the 36358
comparison, the department and consulting pharmacy benefit manager 36359
shall express the weighted average base price and payment rate in 36360
terms of a discount percentage that is taken from the drugs' 36361
average wholesale price, as identified by a national drug price 36362
reporting service selected by the department and the consulting 36363
pharmacy benefit manager.36364

       After conducting the review, the consulting pharmacy benefit 36365
manager shall provide information to the department verifying 36366
whether the discount percentage reflected in the department's 36367
weighted average base price for the drugs is more than two 36368
percentage points below the equivalent part of the consulting 36369
pharmacy benefit manager's weighted average payment rate for the 36370
same drugs. The information provided to the department shall be 36371
certified by signature of an officer of the consulting pharmacy 36372
benefit manager.36373

       Sec. 173.75.        Sec. 5169.05. (A) Subject to division (B) of this 36374
section, the amount that an Ohio's best Rx program participant is 36375
to be charged for a quantity of a drug purchased under the program 36376
shall be established in accordance with all of the following:36377

       (1) If the drug is not included in a manufacturer agreement 36378
entered into under section 173.815169.11 of the Revised Code, the 36379
participant shall be charged an amount that is computed according 36380
to the drug's base price established under section 173.745169.0436381
of the Revised Code.36382

       (2) If the drug is included in a manufacturer agreement 36383
entered into under section 173.815169.11 of the Revised Code, the 36384
participant shall be charged an amount that is computed by 36385
subtracting from the drug's base price established under section 36386
173.745169.04 of the Revised Code the amount of the manufacturer 36387
payment that applies to the transaction, as established under 36388
section 173.8125169.112 of the Revised Code.36389

       (3) If an administrative fee is specified in rules adopted 36390
under section 173.835169.13 of the Revised Code, the participant 36391
shall be charged the amount of the administrative fee.36392

       (4) If the drug is dispensed by a terminal distributor of 36393
dangerous drugs under an agreement entered into under section 36394
173.795169.09 of the Revised Code, and the terminal distributor 36395
charges a professional fee pursuant to the agreement, the 36396
participant shall be charged the amount of the professional fee.36397

       (5) If the drug is dispensed through the drug mail order 36398
system included in the program pursuant to section 173.785169.0836399
of the Revised Code, the participant shall not be charged a 36400
professional fee.36401

        (B) When a quantity of a drug is purchased by an Ohio's best 36402
Rx program participant, the participating terminal distributor or 36403
drug mail order system dispensing the drug shall charge the lesser 36404
of the amount that applies to the transaction, as established in 36405
accordance with division (A) of this section, or the usual and 36406
customary charge that otherwise would apply to the transaction. 36407
When a drug is purchased at the usual and customary charge 36408
pursuant to this division, the transaction is not subject to 36409
sections 173.715169.01 to 173.915169.21 of the Revised Code as 36410
the purchase or dispensing of a drug under the program.36411

       Sec. 173.751.        Sec. 5169.051.  The department of aginghealth care 36412
administration shall report the following to each participating 36413
terminal distributor and the drug mail order system included in 36414
the Ohio's best Rx program pursuant to section 173.785169.08 of 36415
the Revised Code in a manner enabling the distributor and system 36416
to comply with section 173.755169.05 of the Revised Code:36417

       (A) For each drug included in the program, the amount to be 36418
charged under division (A)(1) or (2) of section 173.755169.05 of 36419
the Revised Code;36420

       (B) The administrative fee, if any, specified by the 36421
department in rules adopted under section 173.835169.13 of the 36422
Revised Code.36423

       Sec. 173.752.        Sec. 5169.052. The amount that an Ohio's best Rx 36424
program participant saves when a drug is purchased under the 36425
program shall be determined by subtracting the amount that the 36426
participant is charged in accordance with division (A) of section 36427
173.755169.05 of the Revised Code from the usual and customary 36428
charge that otherwise would apply to the transaction.36429

       Sec. 173.753.        Sec. 5169.053.  Not later than the first day of March 36430
of each year, the department of aginghealth care administration36431
shall do all of the following:36432

       (A) Create a list of the twenty-five drugs most often 36433
dispensed to Ohio's best Rx program participants under the 36434
program, using data from the most recent six-month period for 36435
which the data is available;36436

       (B) Determine the average amount that participants are 36437
charged under the program, on a date selected by the department, 36438
for each drug included on the list created under division (A) of 36439
this section;36440

       (C) Determine, for the date selected for division (B) of this 36441
section, the average usual and customary charge for each drug 36442
included on the list created under division (A) of this section;36443

       (D) By comparing the average charges determined under 36444
divisions (B) and (C) of this section, determine the average 36445
percentage savings Ohio's best Rx program participants receive for 36446
each drug included on the list created under division (A) of this 36447
section.36448

       Sec. 173.76.        Sec. 5169.06. (A) To be eligible for the Ohio's best 36449
Rx program, an individual must meet all of the following 36450
requirements at the time of application for the program:36451

       (1) The individual must be a resident of this state.36452

       (2) One of the following must be the case:36453

        (a) The individual has family income, as determined under 36454
rules adopted pursuant to section 173.835169.13 of the Revised 36455
Code, that does not exceed three hundred per cent of the federal 36456
poverty guidelines, as revised annually by the United States 36457
department of health and human services in accordance with section 36458
673(2) of the "Omnibus Budget Reconciliation Act of 1981," 95 36459
Stat. 511, 42 U.S.C. 9902, as amended;36460

        (b) The individual is sixty years of age or older;36461

       (c) The individual is a person with a disability, as defined 36462
in section 173.06 of the Revised Code.36463

       (3) Except as provided in division (B) of this section, the 36464
individual must not have coverage for outpatient drugs paid for in 36465
whole or in part by any of the following:36466

       (a) A third-party payer, including an employer;36467

       (b) The medicaid program;36468

       (c) The children's health insurance program;36469

       (d) The disability medical assistance program;36470

       (e) Another health plan or pharmacy assistance program that 36471
uses state or federal funds to pay part or all of the cost of the 36472
individual's outpatient drugs.36473

       (4) The individual must not have had coverage for outpatient 36474
drugs paid for by any of the entities or programs specified in 36475
division (A)(3) of this section during any of the four months 36476
preceding the month in which the application for the Ohio's best 36477
Rx program is made, unless any of the following applies:36478

       (a) The individual is sixty years of age or older.36479

       (b) The third-party payer, including an employer, that paid 36480
for the coverage filed for bankruptcy under federal bankruptcy 36481
laws.36482

       (c) The individual is no longer eligible for coverage 36483
provided through a retirement plan subject to protection under the 36484
"Employee Retirement Income Security Act of 1974," 88 Stat. 832, 36485
29 U.S.C. 1001, as amended.36486

       (d) The individual is no longer eligible for the medicaid 36487
program, children's health insurance program, or disability 36488
medical assistance program.36489

       (e) The individual is either temporarily or permanently 36490
discharged from employment due to a business reorganization.36491

       (B) An individual is not subject to division (A)(3) of this 36492
section if the individual has coverage for outpatient drugs paid 36493
for in whole or in part by either of the following:36494

        (1) The workers' compensation program;36495

       (2) A medicare prescription drug plan offered pursuant to the 36496
"Medicare Prescription Drug, Improvement, and Modernization Act of 36497
2003," 117 Stat. 2071, 42 U.S.C. 1395w-101, as amended, but only 36498
if all of the following are the case with respect to the 36499
particular drug being purchased through the Ohio's best Rx 36500
program:36501

       (a) The individual is responsible for the full cost of the 36502
drug.36503

        (b) The drug is not subject to a rebate from the manufacturer 36504
under the individual's medicare prescription drug plan.36505

       (c) The manufacturer of the drug has agreed to the Ohio's 36506
best Rx program's inclusion of individuals who have coverage 36507
through a medicare prescription drug plan.36508

       Sec. 173.77.        Sec. 5169.07. Application for participation in the 36509
Ohio's best Rx program shall be made in accordance with rules 36510
adopted by the department of aginghealth care administration36511
under section 173.835169.13 of the Revised Code. When applying 36512
for participation, an individual may include application for 36513
participation by the individual's spouse and children. An 36514
individual's guardian or custodian may apply on behalf of the 36515
individual.36516

       When submitting an application, the applicant shall include 36517
the information and documentation specified in the department's 36518
rules as necessary to verify eligibility for the program. The 36519
application may be submitted on a paper form prescribed and 36520
supplied by the department or pursuant to any other application 36521
method the department makes available for the program, including 36522
methods that permit an individual to apply by telephone or through 36523
the internet.36524

       An applicant shall attest that the information and 36525
documentation the applicant submits with an application is 36526
accurate to the best knowledge and belief of the applicant. In the 36527
case of a paper application form, the applicant's signature shall 36528
be used to certify that the applicant has attested to the accuracy 36529
of the information and documentation. In the case of other 36530
application methods, the application certification process 36531
specified in the department's rules shall be used to certify that 36532
the applicant has attested to the accuracy of the information and 36533
documentation.36534

        The department shall inform each applicant that knowingly 36535
making a false statement in an application is falsification under 36536
section 2921.13 of the Revised Code, a misdemeanor of the first 36537
degree. In the case of a paper application form, the department 36538
shall provide the information by including on the form a statement 36539
printed in bold letters.36540

       Sec. 173.771.        Sec. 5169.071.  The department of aginghealth care 36541
administration shall provide each applicant for the Ohio's best Rx 36542
program information about the medicaid program in accordance with 36543
rules adopted under section 173.835169.13 of the Revised Code. 36544
The information shall include general eligibility requirements, 36545
application procedures, and benefits. The information shall also 36546
explain the ways in which the medicaid program's drug benefits are 36547
better than the Ohio's best Rx program.36548

       Sec. 173.772.        Sec. 5169.072. On receipt of applications, the 36549
department of aginghealth care administration shall make 36550
eligibility determinations for the Ohio's best Rx program in 36551
accordance with procedures established in rules adopted under 36552
section 173.835169.13 of the Revised Code.36553

       An eligibility determination under this section may not be 36554
appealed under Chapter 119., section 5101.35, or any other 36555
provision of the Revised Code.36556

       Sec. 173.773.        Sec. 5169.073. (A) The department of aginghealth 36557
care administration shall issue Ohio's best Rx program enrollment 36558
cards to or on behalf of individuals determined eligible to 36559
participate. One enrollment card may cover each member of a family 36560
determined eligible to participate.36561

       The department shall determine the information to be included 36562
on the card, including an identification number, and shall 36563
determine the card's size and format. If the department 36564
establishes an application method that permits individuals to 36565
apply through the internet, the department may issue the 36566
enrollment card by sending the applicant an electronic version of 36567
the card in a printable format.36568

       (B) Each time a drug is purchased under the program, the 36569
entity dispensing the drug shall confirm whether the individual 36570
for whom the drug is dispensed is enrolled in the program. If the 36571
drug is being purchased from a participating terminal distributor 36572
rather than the drug mail order system included in the program 36573
pursuant to section 173.785169.08 of the Revised Code, and the 36574
individual's enrollment card is available for presentation at the 36575
time of the purchase, the purchaser shall present the card to the 36576
participating terminal distributor as confirmation of the 36577
individual's enrollment in the program. If the drug is being 36578
purchased through the drug mail order system and the individual's 36579
program identification number is available, the purchaser shall 36580
present the identification number as confirmation of enrollment. 36581
Otherwise, the terminal distributor or mail order system shall 36582
confirm the individual's enrollment through the department. The 36583
department shall establish the methods to be used in confirming 36584
enrollment through the department, including confirmation by 36585
telephone, through the internet, or by any other electronic means.36586

       (C) Purchasing a drug under the program by using an 36587
enrollment card or any other method shall serve as an attestation 36588
by the participant for whom the drug is dispensed that the 36589
participant meets the eligibility requirements specified in 36590
division (A)(3) of section 173.765169.06 of the Revised Code 36591
regarding not having coverage for outpatient drugs.36592

       Sec. 173.78.        Sec. 5169.08. (A) For purposes of making drugs 36593
included in the Ohio's best Rx program available to participants 36594
by mail, the department of aginghealth care administration shall 36595
include a drug mail order system within the program. Not more than 36596
one drug mail order system shall be included in the program. 36597
Subject to division (B) of this section, the program's drug mail 36598
order system shall be provided in accordance with rules adopted 36599
under section 173.835169.13 of the Revised Code.36600

       (B) Neither the department nor the drug mail order system 36601
shall promote the purchase of drugs through the system by using 36602
information collected under the program regarding the drugs 36603
purchased by participants from participating terminal 36604
distributors. This division does not preclude the use of the 36605
information for purposes of limiting the amount that a participant 36606
may be charged for a quantity of a drug purchased through the drug 36607
mail order system to an amount that is not more than the amount 36608
that would be charged if the same quantity of the drug were 36609
purchased from a participating terminal distributor.36610

       Sec. 173.79.        Sec. 5169.09.  (A) For purposes of making drugs 36611
included in the Ohio's best Rx program available to participants 36612
from terminal distributors of dangerous drugs other than the drug 36613
mail order system included in the program pursuant to section 36614
173.785169.08 of the Revised Code, the department of aginghealth 36615
care administration shall enter into agreements under this section 36616
with terminal distributors of dangerous drugs. Any terminal 36617
distributor of dangerous drugs may enter into an agreement with 36618
the department to participate in the program pursuant to this 36619
section. 36620

       Before entering into an agreement with a terminal 36621
distributor, the department shall provide the terminal distributor 36622
with one of the following:36623

       (1) A formula that allows the terminal distributor to 36624
calculate for each drug included in the program the amount to be 36625
charged under division (A)(1) or (2) of section 173.755169.05 of 36626
the Revised Code by participating terminal distributors.36627

       (2) A statistically valid sampling of drug prices that 36628
includes the amount to be charged under division (A)(1) or (2) of 36629
section 173.755169.05 of the Revised Code by participating 36630
terminal distributors for not fewer than two brand name drugs and 36631
two generic drugs from each category of drugs included in the 36632
program.36633

       (3) The current amount to be charged under division (A)(1) or 36634
(2) of section 173.755169.05 of the Revised Code by participating 36635
terminal distributors for each drug included in the program.36636

       (B) An agreement entered into under this section shall do all 36637
of the following:36638

       (1) Except as provided in division (B)(3) of this section, be 36639
in effect for not less than one year;36640

        (2) Specify the dates that the agreement is to begin and end;36641

        (3) Permit the terminal distributor to terminate the 36642
agreement before the date the agreement would otherwise end as 36643
specified pursuant to division (B)(2) of this section by providing 36644
the department notice of early termination at least thirty days 36645
before the effective date of the early termination;36646

       (4) Require that the terminal distributor comply with section 36647
173.755169.05 of the Revised Code when charging for a drug 36648
purchased under the program;36649

       (5) Permit the terminal distributor to add to the amount to 36650
be charged under division (A)(1) or (2) of section 173.755169.0536651
of the Revised Code a professional fee in an amount not to exceed, 36652
except as provided in rules adopted under section 173.835169.1336653
of the Revised Code, three dollars;36654

       (6) Require the terminal distributor to disclose to each 36655
participant the amount the participant saves under the program as 36656
determined in accordance with section 173.7525169.052 of the 36657
Revised Code;36658

       (7) Require the terminal distributor to submit a claim to the 36659
department under section 173.805169.10 of the Revised Code for 36660
each sale of a drug to a participant;36661

       (8) Permit the terminal distributor to deliver drugs to 36662
Ohio's best Rx program participants by mail, but not by using a 36663
drug mail order system operated in the same manner as the system 36664
included in the program pursuant to section 173.785169.08 of the 36665
Revised Code.36666

       Sec. 173.791.        Sec. 5169.091.  A terminal distributor of dangerous 36667
drugs shall not be prohibited from participating in any program or 36668
any network of health care providers on the basis that the 36669
terminal distributor has not entered into an agreement under 36670
section 173.795169.09 of the Revised Code to participate in the 36671
Ohio's best Rx program.36672

       Sec. 173.80.        Sec. 5169.10.  For each drug dispensed under the 36673
Ohio's best Rx program, a claim shall be submitted to the 36674
department of aginghealth care administration. The participating 36675
terminal distributor or the drug mail order system included in the 36676
program pursuant to section 173.785169.08 of the Revised Code 36677
that dispensed the drug shall submit the claim not later than 36678
thirty days after the drug is dispensed. The claim shall be 36679
submitted in accordance with the electronic method provided for in 36680
rules adopted under section 173.835169.13 of the Revised Code.36681

        The claim shall specify all of the following:36682

       (A) The prescription number of the participant's prescription 36683
under which the drug was dispensed to the participant;36684

       (B) The name of, and national drug code number for, the drug 36685
dispensed to the participant;36686

       (C) The number of units of the drug dispensed to the 36687
participant;36688

       (D) The amount the participant was charged for the drug;36689

       (E) The date the drug was dispensed to the participant;36690

       (F) Any additional information required by rules adopted 36691
under section 173.835169.13 of the Revised Code.36692

       Sec. 173.801.        Sec. 5169.101. (A) In accordance with rules adopted 36693
under section 173.835169.13 of the Revised Code and subject to 36694
section 173.8035169.103 of the Revised Code, the department of 36695
aginghealth care administration shall make payments under the 36696
Ohio's best Rx program for complete and timely claims submitted 36697
under section 173.805169.10 of the Revised Code for drugs 36698
included in the program that are also included in a manufacturer 36699
agreement entered into under section 173.815169.11 of the Revised 36700
Code. The payment for a complete and timely claim shall be made by 36701
a date that is not later than two weeks after the department 36702
receives the claim from the participating terminal distributor or 36703
the drug mail order system included in the program pursuant to 36704
section 173.785169.08 of the Revised Code.36705

       (B) Subject to division (D) of this section, the amount to be 36706
paid for a claim for a drug dispensed under the program shall be 36707
determined as follows:36708

        (1) Compute the manufacturer payment amount that applies to 36709
the transaction, based on quantity of the drug dispensed and the 36710
drug's national drug code number, in accordance with the 36711
provisions of division (B) of section 173.8125169.112 of the 36712
Revised Code;36713

        (2) If rules adopted under section 173.835169.13 of the 36714
Revised Code require that program participants be charged an 36715
administrative fee for each transaction in which a quantity of the 36716
drug was dispensed, subtract from the amount computed under 36717
division (B)(1) of this section the administrative fee amount 36718
specified in those rules.36719

        (C) The department may combine the claims submitted by a 36720
participating terminal distributor or the program's drug mail 36721
order system to make aggregate payments under this section to the 36722
distributor or system.36723

        (D) If the total of the amounts computed under division (B) 36724
of this section for any period for which payments are due is a 36725
negative number, the participating terminal distributor or the 36726
program's drug mail order system that submitted the claims has 36727
been overpaid for the claims. When there is an overpayment, the 36728
department shall reduce future payments made under this section to 36729
the distributor or system or collect an amount from the 36730
distributor or system sufficient to reimburse the department for 36731
the overpayment.36732

       Sec. 173.802.        Sec. 5169.102.  Neither a participating terminal 36733
distributor nor the drug mail order system included in the Ohio's 36734
best Rx program pursuant to section 173.785169.08 of the Revised 36735
Code may be charged by the department of aginghealth care 36736
administration for the submission of a claim under section 173.8036737
5169.10 of the Revised Code or the processing of a claim under 36738
section 173.8015169.101 of the Revised Code.36739

       Sec. 173.803.        Sec. 5169.103. The department of aginghealth care 36740
administration may not make a payment under section 173.80136741
5169.101 of the Revised Code for a claim submitted under section 36742
173.805169.10 of the Revised Code if any of the following are the 36743
case:36744

        (A) The claim is submitted by either a terminal distributor 36745
of dangerous drugs that is not a participating terminal 36746
distributor or a drug mail order system that is not the system 36747
included in the Ohio's best Rx program pursuant to section 173.7836748
5169.08 of the Revised Code.36749

        (B) The claim is for a drug that is not included in the 36750
program.36751

        (C) The claim is for a drug included in the program but the 36752
drug is dispensed to an individual who is not covered by an Ohio's 36753
best Rx program enrollment card.36754

        (D) A person or government entity has paid the participating 36755
terminal distributor or the program's drug mail order system 36756
through any other prescription drug coverage program or 36757
prescription drug discount program for dispensing the drug, unless 36758
the payment is reimbursement for redeeming a coupon or is an 36759
amount directly paid by a drug manufacturer to the distributor or 36760
system for dispensing drugs to residents of a long-term care 36761
facility.36762

       Sec. 173.81.        Sec. 5169.11. For purposes of participating in the 36763
Ohio's best Rx program, any drug manufacturer may enter into an 36764
agreement with the department of aginghealth care administration36765
under which the manufacturer agrees to make payments to the 36766
department with respect to one or more of the manufacturer's drugs 36767
when the one or more drugs are dispensed under the program. The 36768
terms of the agreement shall comply with section 173.8115169.11136769
of the Revised Code.36770

       Sec. 173.811.        Sec. 5169.111.  (A) A manufacturer agreement entered 36771
into under section 173.815169.11 of the Revised Code by a drug 36772
manufacturer and the department of aginghealth care 36773
administration shall include terms that do all of the following:36774

       (1) Specify the time the agreement is to be in effect, which 36775
shall be not less than one year from the date the agreement is 36776
entered into;36777

       (2) Specify which of the manufacturer's drugs are included in 36778
the agreement;36779

       (3) Permit the department to remove a drug from the agreement 36780
in the event of a dispute over the drug's utilization;36781

       (4) Require that the manufacturer specify a per unit amount 36782
that will be paid to the department for each drug included in the 36783
agreement that is dispensed to an Ohio's best Rx program 36784
participant;36785

       (5) Require that the per unit amount specified by the 36786
manufacturer be an amount that the manufacturer believes is 36787
greater than or comparable to the per unit amount generally 36788
payable by the manufacturer for the same drug when the drug is 36789
dispensed to an individual using the outpatient drug coverage 36790
included in a health benefit plan offered in this state or another 36791
state to public employees or retirees and the eligible dependents 36792
of those employees or retirees;36793

       (6) Require the manufacturer to make payments in accordance 36794
with the amounts computed under division (A) of section 173.81236795
5169.112 of the Revised Code;36796

       (7) Require that the manufacturer make the payments on a 36797
quarterly basis or in accordance with a schedule established by 36798
rules adopted under section 173.835169.13 of the Revised Code.36799

       (B) For any drug included in a manufacturer agreement, the 36800
terms of the agreement may provide for the establishment of a 36801
process for referring Ohio's best Rx program applicants and 36802
participants to a patient assistance program operated or sponsored 36803
by the manufacturer. The referral process may be included only if 36804
the manufacturer agrees to refer to the Ohio's best Rx program 36805
residents of this state who apply but are found to be ineligible 36806
for the patient assistance program.36807

       Sec. 173.812.        Sec. 5169.112. When a drug included in a manufacturer 36808
agreement entered into under section 173.815169.11 of the Revised 36809
Code is dispensed under the Ohio's best Rx program, the 36810
manufacturer payment amount that applies to the transaction shall 36811
be established in accordance with the following:36812

       (A) For purposes of the amount to be paid by the 36813
manufacturer, the manufacturer payment amount shall be computed by 36814
multiplying the per unit amount specified for the drug in the 36815
manufacturer agreement by the number of units dispensed.36816

       (B) For purposes of the amount that a participant is to be 36817
charged under section 173.755169.05 of the Revised Code and the 36818
amount to be paid for claims under section 173.8015169.101 of the 36819
Revised Code, both of the following apply:36820

       (1) If a program administration percentage is not determined 36821
by the department of aginghealth care administration in rules 36822
adopted under section 173.835169.13 of the Revised Code, the 36823
manufacturer payment amount shall be the same as the manufacturer 36824
payment amount computed under division (A) of this section.36825

       (2) If a program administration percentage is determined by 36826
the department, the manufacturer payment amount shall be computed 36827
as follows:36828

       (a) Multiply the per unit amount specified for the drug in 36829
the agreement by the program administration percentage;36830

       (b) Subtract the product determined under division (B)(2)(a) 36831
of this section from the per unit amount specified for the drug in 36832
the agreement;36833

       (c) Multiply the per unit amount resulting from the 36834
computation under division (B)(2)(b) of this section by the number 36835
of units dispensed.36836

       Sec. 173.813.        Sec. 5169.113. In its negotiations with a drug 36837
manufacturer proposing to enter into an agreement under section 36838
173.815169.11 of the Revised Code, the department of aginghealth 36839
care administration shall use the best information on manufacturer 36840
payments that is available to the department, including 36841
information obtained from the verifications made under section 36842
173.8145169.114 of the Revised Code by the Ohio's best Rx 36843
program's consulting pharmacy benefit manager selected under 36844
section 173.7315169.031 of the Revised Code. The department shall 36845
use the information in an attempt to obtain manufacturer payments 36846
that maximize the benefits provided to Ohio's best Rx program 36847
participants.36848

       Sec. 173.814.        Sec. 5169.114. Annually, the department of aging36849
health care administration shall select a sample of not more than 36850
ten of the drugs that were included in the manufacturer agreements 36851
entered into under section 173.815169.11 of the Revised Code in 36852
the immediately preceding year. The department shall submit to the 36853
program's consulting pharmacy benefit manager selected under 36854
section 173.7315169.031 of the Revised Code information that 36855
identifies the per unit amount of the manufacturer payments that 36856
applied to each of the drugs in the sample.36857

       The consulting pharmacy benefit manager shall review the 36858
submitted information. After the review, the consulting pharmacy 36859
benefit manager shall provide information to the department 36860
verifying whether any of the per unit payment amounts that applied 36861
to the selected drugs were more than two per cent lower than the 36862
per unit payment amounts negotiated by the consulting pharmacy 36863
benefit manager for the same drugs in connection with health 36864
benefit plans that generally do not use formularies to restrict 36865
the outpatient drug coverage included in the plans. The consulting 36866
pharmacy benefit manager shall specify which, if any, of the drugs 36867
in the sample were subject to the lower per unit payment amounts. 36868
The information provided to the department shall be certified by 36869
signature of an officer of the consulting pharmacy benefit 36870
manager.36871

       Sec. 173.815.        Sec. 5169.115.  (A) The department of aginghealth 36872
care administration shall seek from the centers for medicare and 36873
medicaid services of the United States department of health and 36874
human services written confirmation that manufacturer payments 36875
made pursuant to an agreement entered into under section 173.8136876
5169.11 of the Revised Code are exempt from the medicaid best 36877
price computation applicable under Title XIX of the "Social 36878
Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396r-8, as 36879
amended.36880

       (B) Entering into a manufacturer agreement under section 36881
173.815169.11 of the Revised Code does not require a drug 36882
manufacturer to make a manufacturer payment that would establish 36883
the manufacturer's medicaid best price for a drug.36884

       Sec. 173.82.        Sec. 5169.12. A drug manufacturer that enters into an 36885
agreement under section 173.815169.11 of the Revised Code may 36886
submit a request to the department of aginghealth care 36887
administration to audit claims submitted under section 173.8036888
5169.10 of the Revised Code. On submission of a request that the 36889
department considers reasonable, the department shall permit the 36890
manufacturer to audit the claims.36891

       Sec. 173.83.        Sec. 5169.13.  The department of aginghealth care 36892
administration shall adopt rules in accordance with Chapter 119. 36893
of the Revised Code to implement the Ohio's best Rx program. The 36894
rules shall provide for all of the following:36895

       (A) Standards and procedures for establishing, pursuant to 36896
section 173.745169.04 of the Revised Code, the base price for 36897
each drug included in the program;36898

       (B) Determination of family income for the purpose of 36899
division (A)(2)(a) of section 173.765169.06 of the Revised Code;36900

       (C) For the purpose of section 173.775169.07 of the Revised 36901
Code, the application process for the program, including the 36902
information and documentation to be submitted with applications to 36903
verify eligibility and a process to be used in certifying that an 36904
applicant has attested to the accuracy of the submitted 36905
information and documentation;36906

       (D) The method of providing information about the medicaid 36907
program to applicants under section 173.7715169.071 of the 36908
Revised Code;36909

       (E) For the purpose of section 173.7725169.072 of the 36910
Revised Code, eligibility determination procedures;36911

       (F) Standards and procedures governing the drug mail order 36912
system included in the program pursuant to section 173.785169.0836913
of the Revised Code;36914

       (G) Subject to section 173.8315169.131 of the Revised Code, 36915
periodically increasing the maximum professional fee that 36916
participating terminal distributors may charge Ohio's best Rx 36917
program participants pursuant to an agreement entered into under 36918
section 173.795169.09 of the Revised Code;36919

       (H) Subject to section 173.8325169.132 of the Revised Code, 36920
the amount of the administrative fee, if any, that Ohio's best Rx 36921
program participants are to be charged under the program;36922

       (I) The electronic method for submission of claims to the 36923
department under section 173.805169.10 of the Revised Code;36924

       (J) Additional information to be included on claims submitted 36925
under section 173.805169.10 of the Revised Code that the 36926
department determines is necessary for the department to be able 36927
to make payments under section 173.8015169.101 of the Revised 36928
Code;36929

       (K) The method for making payments under section 173.80136930
5169.101 of the Revised Code;36931

       (L) Subject to section 173.8335169.133 of the Revised Code, 36932
the percentage, if any, that is the program administration 36933
percentage;36934

       (M) If the department determines it is best that 36935
participating manufacturers make payments pursuant to manufacturer 36936
agreements entered into under section 173.815169.11 of the 36937
Revised Code on a basis other than quarterly, a schedule for 36938
making the payments;36939

       (N) Procedures for making computations under sections 173.7536940
5169.05 and 173.8125169.112 of the Revised Code;36941

       (O) Standards and procedures for the use and preservation of 36942
records regarding the Ohio's best Rx program pursuant to section 36943
173.915169.21 of the Revised Code;36944

        (P) The efficient administration of other provisions of 36945
sections 173.715169.01 to 173.915169.21 of the Revised Code for 36946
which the department determines rules are necessary.36947

       Sec. 173.831.        Sec. 5169.131.  As used in this section, "medicaid 36948
dispensing fee" means the dispensing fee established under section 36949
5111.0715163.251 of the Revised Code for the medicaid program.36950

       In adopting a rule under division (G) of section 173.8336951
5169.13 of the Revised Code increasing the maximum amount of the 36952
professional fee participating terminal distributors may charge 36953
Ohio's best Rx program participants pursuant to an agreement 36954
entered into under section 173.795169.09 of the Revised Code, the 36955
department of aginghealth care administration shall review the 36956
amount of the professional fee once a year or, at the department's 36957
discretion, at more frequent intervals. The department shall not 36958
increase the professional fee to an amount exceeding the medicaid 36959
dispensing fee.36960

       A participating terminal distributor may charge a maximum 36961
three dollar professional fee regardless of whether the medicaid 36962
dispensing fee for that drug is less than that amount. The 36963
department, however, may not adopt a rule increasing the maximum 36964
professional fee for that drug until the medicaid dispensing fee 36965
for that drug exceeds that amount.36966

       Sec. 173.832.        Sec. 5169.132. (A) Once a year or, at the discretion 36967
of the department of aginghealth care administration, at more 36968
frequent intervals, the department shall determine the amount, if 36969
any, that each Ohio's best Rx program participant will be charged 36970
as an administrative fee to be used in paying the administrative 36971
costs of the program. The fee, which shall not exceed one dollar 36972
per transaction, shall be specified in rules adopted under section 36973
173.835169.13 of the Revised Code. In adopting the rules, the 36974
department shall specify a fee that results in an amount that 36975
equals or is less than the amount needed to cover the 36976
administrative costs of the Ohio's best Rx program when added to 36977
the sum of the following:36978

       (1) The amount resulting from the program administration 36979
percentage, if the department determines a program administration 36980
percentage in rules adopted under section 173.835169.13 of the 36981
Revised Code;36982

       (2) The investment earnings of the Ohio's best Rx program 36983
fund created by section 173.855169.15 of the Revised Code;36984

        (3) Any amounts accepted by the department as donations to 36985
the Ohio's best Rx program fund.36986

       (B) Once a year or, at the discretion of the department, at 36987
more frequent intervals, the department shall report the 36988
methodology underlying the determination of the administrative fee 36989
to the Ohio's best Rx program council.36990

       Sec. 173.833.        Sec. 5169.133. (A) At least once a year or, at the 36991
discretion of the department of aginghealth care administration, 36992
at more frequent intervals, the department shall determine the 36993
percentage, if any, of each manufacturer payment made under an 36994
agreement entered into under section 173.815169.11 of the Revised 36995
Code that will be retained by the department for use in paying the 36996
administrative costs of the Ohio's best Rx program. The 36997
percentage, which shall not exceed five per cent, shall be 36998
specified in rules adopted under section 173.835169.13 of the 36999
Revised Code. In adopting the rules, the department shall specify 37000
a percentage that results in an amount that equals or is less than 37001
the amount needed to cover the administrative costs of the Ohio's 37002
best Rx program when added to the sum of the following:37003

       (1) The amount resulting from administrative fees, if the 37004
department determines an administrative fee in rules adopted under 37005
section 173.835169.13 of the Revised Code;37006

       (2) The investment earnings of the Ohio's best Rx program 37007
fund created by section 173.855169.15 of the Revised Code;37008

        (3) Any amounts accepted by the department as donations to 37009
the Ohio's best Rx program fund.37010

       (B) Once a year or, at the discretion of the department, at 37011
more frequent intervals, the department shall report the 37012
methodology underlying the determination of the program 37013
administration percentage to the Ohio's best Rx program council.37014

       Sec. 173.84.        Sec. 5169.14.  Notwithstanding any conflicting 37015
provision of sections 173.715169.01 to 173.915169.21 of the 37016
Revised Code, the department of aginghealth care administration37017
may adopt rules in accordance with Chapter 119. of the Revised 37018
Code to make adjustments to the Ohio's best Rx program that the 37019
department considers appropriate to conform the program to, or 37020
coordinate it with, any federally funded prescription drug program 37021
created after October 1, 2003.37022

       Sec. 173.85.        Sec. 5169.15.  (A) The Ohio's best Rx program fund is 37023
hereby created in the state treasury. The fund shall consist of 37024
the following:37025

       (1) Manufacturer payments made by participating manufacturers 37026
pursuant to agreements entered into under section 173.81 of the 37027
Revised Code;37028

       (2) Administrative fees, if an administrative fee is 37029
determined by the department of aginghealth care administration37030
in rules adopted under section 173.835169.13 of the Revised 37031
Code;37032

       (3) Any amounts donated to the fund and accepted by the 37033
department;37034

        (4) The fund's investment earnings.37035

       (B) Money in the Ohio's best Rx program fund shall be used to 37036
make payments under section 173.8015169.101 of the Revised Code 37037
and to make transfers to the Ohio's best Rx administration fund 37038
in accordance with section 173.865169.16 of the Revised Code.37039

       Sec. 173.86.        Sec. 5169.16.  (A) The Ohio's best Rx administration 37040
fund is hereby created in the state treasury. The director of 37041
budget and management shall transfer from the Ohio's best Rx 37042
program fund to the Ohio's best Rx administration fund amounts 37043
equal to the following:37044

       (1) Amounts resulting from application of the program 37045
administration percentage, if a program administration percentage 37046
is determined by the department of aginghealth care 37047
administration in rules adopted under section 173.835169.13 of 37048
the Revised Code;37049

       (2) The amount of the administrative fees charged Ohio's best 37050
Rx participants, if an administrative fee is determined by the 37051
department of aginghealth care administration in rules adopted 37052
under section 173.835169.13 of the Revised Code;37053

       (3) The amount of any donations credited to the Ohio's best 37054
Rx program fund;37055

        (4) The amount of investment earnings credited to the Ohio's 37056
best Rx program fund.37057

       The director of budget and management shall make the 37058
transfers in accordance with a schedule developed by the director 37059
and the department of aginghealth care administration.37060

       (B) The department of aginghealth care administration shall 37061
use money in the Ohio's best Rx administration fund to pay the 37062
administrative costs of the Ohio's best Rx program, including, 37063
but not limited to, costs associated with contracted services, 37064
staff, outreach activities, computers and network services, and 37065
the Ohio's best Rx program council. If the fund includes an 37066
amount that exceeds the amount necessary to pay the 37067
administrative costs of the program, the department may use the 37068
excess amount to pay the cost of subsidies provided to Ohio's 37069
best Rx program participants under any subsidy program 37070
established pursuant to section 173.8615169.161 of the Revised 37071
Code.37072

       Sec. 173.861.        Sec. 5169.161. The department of aginghealth care 37073
administration may establish a component of the Ohio's best Rx 37074
program under which subsidies are provided to participants to 37075
assist them with the cost of purchasing drugs under the program, 37076
including the cost of any professional fees charged for dispensing 37077
the drugs. The subsidies shall be provided only when the Ohio's 37078
best Rx administration fund created under section 173.865169.1637079
of the Revised Code includes an amount that exceeds the amount 37080
necessary to pay the administrative costs of the program.37081

       Sec. 173.87.        Sec. 5169.17.  There is hereby created the Ohio's best 37082
Rx program council. The council shall advise the department of 37083
aginghealth care administration on the Ohio's best Rx program. 37084
With the approval of a majority of the council's appointed 37085
members, the council may initiate studies to determine whether 37086
there are more effective ways to administer the program and 37087
provide the department with suggestions for improvements.37088

       Sec. 173.871.        Sec. 5169.171.  The Ohio's best Rx program council 37089
shall consist of the following members:37090

       (A) The president of the senate;37091

       (B) The speaker of the house of representatives;37092

       (C) The minority leader of the senate;37093

       (D) The minority leader of the house of representatives;37094

       (E) A representative of the Ohio chapter of the American 37095
federation of labor-congress of industrial organizations, 37096
appointed by the governor from a list of names submitted to the 37097
governor by that organization;37098

       (F) A representative of the Ohio chapter of the American 37099
association of retired persons, appointed by the governor from a 37100
list of names submitted to the governor by that organization;37101

       (G) A representative of a disability advocacy organization 37102
located in the state of Ohio, appointed by the governor from a 37103
list of names submitted to the governor by disability advocacy 37104
organizations located in the state of Ohio;37105

       (H) A representative of the Ohio chapter of the united way, 37106
appointed by the governor from a list of names submitted to the 37107
governor by that organization;37108

       (I) A representative of the Ohio alliance of retired 37109
Americans, appointed by the governor from a list of names 37110
submitted to the governor by that organization;37111

       (J) Three representatives of research-based drug 37112
manufacturers, appointed by the governor from a list of names 37113
submitted to the governor by the pharmaceutical research and 37114
manufacturers of America;37115

       (K) A pharmacist licensed under Chapter 4729. of the Revised 37116
Code, appointed by the governor from a list of names submitted to 37117
the governor by the Ohio pharmacists association.37118

       Sec. 173.872.        Sec. 5169.172.  The governor shall make initial 37119
appointments to the Ohio's best Rx program council not later than 37120
thirty days after December 18, 2003. The members appointed by the 37121
governor shall serve at the pleasure of the governor. If an 37122
appointed member's seat becomes vacant, the governor shall fill 37123
the vacancy not later than thirty days after the vacancy occurs 37124
and in the manner provided for the initial appointment.37125

       Sec. 173.873.        Sec. 5169.173.  The president of the senate and 37126
speaker of the house of representatives shall serve as co-chairs 37127
of the Ohio's best Rx program council.37128

       The president of the senate, the minority leader of the 37129
senate, the speaker of the house of representatives, and the 37130
minority leader of the house of representatives may each appoint a 37131
member of the general assembly to attend any meeting of the Ohio's 37132
best Rx program council on behalf of the president of the senate, 37133
the minority leader of the senate, the speaker of the house of 37134
representatives, or the minority leader of the house of 37135
representatives, respectively.37136

       Sec. 173.874.        Sec. 5169.174.  Members of the Ohio's best Rx program 37137
council shall serve without compensation and shall not be 37138
reimbursed for any expenses associated with their duties on the 37139
council.37140

       Sec. 173.875.        Sec. 5169.175. Except for any part of records that 37141
contain a trade secret, the Ohio's best Rx program council's 37142
records are a public record for the purpose of section 149.43 of 37143
the Revised Code.37144

       Sec. 173.876.        Sec. 5169.176. Sections 101.82 to 101.87 of the 37145
Revised Code do not apply to the Ohio's best Rx program council.37146

       Sec. 173.88.        Sec. 5169.18. (A) The department of aginghealth care 37147
administration shall compile both of the following lists regarding 37148
the Ohio's best Rx program:37149

        (1) A list consisting of the name of each drug manufacturer 37150
that enters into a manufacturer agreement under section 173.79137151
5169.091 of the Revised Code and the names of the drugs included 37152
in each manufacturer agreement;37153

        (2) A list consisting of the name of each participating 37154
terminal distributor and the name of the drug mail order system 37155
included in the program pursuant to section 173.785169.08 of the 37156
Revised Code.37157

        (B) As part of the list compiled under division (A)(1) of 37158
this section, the department may include aggregate information 37159
regarding the drugs selected under section 173.8145169.114 of the 37160
Revised Code that were verified under that section as having per 37161
unit manufacturer payment amounts that were not more than two per 37162
cent lower than the per unit payment amounts negotiated for the 37163
same drugs by the program's consulting pharmacy benefit manager 37164
selected under section 173.7315169.031 of the Revised Code. The 37165
information shall not identify a specific drug and shall be 37166
expressed only as a percentage of the sample of drugs selected 37167
under section 173.8145169.114 of the Revised Code.37168

       (C) The lists compiled under this section are public records 37169
for the purpose of section 149.43 of the Revised Code. The 37170
department shall specifically make the lists available to 37171
physicians, participating terminal distributors, and other health 37172
professionals.37173

       Sec. 173.89.        Sec. 5169.19.  Information transmitted by or to any of 37174
the following for any purpose related to the Ohio's best Rx 37175
program is confidential to the extent required by federal and 37176
state law:37177

       (A) Drug manufacturers;37178

       (B) Terminal distributors of dangerous drugs;37179

       (C) The department of aginghealth care administration;37180

       (D) The program's consulting pharmacy benefit manager 37181
selected under section 173.7315169.031 of the Revised Code;37182

       (E) Ohio's best Rx program participants;37183

       (F) Any other government entity or person.37184

       Sec. 173.891.        Sec. 5169.191.  (A) Except as provided by section 37185
173.8925169.192 of the Revised Code, all of the following are 37186
trade secrets, are not public records for the purposes of section 37187
149.43 of the Revised Code, and shall not be used, released, 37188
published, or disclosed in a form that reveals a specific drug or 37189
the identity of a drug manufacturer:37190

       (1) The amounts determined under section 173.8015169.101 of 37191
the Revised Code for payment of claims submitted by participating 37192
terminal distributors and the drug mail order system included in 37193
the Ohio's best Rx program pursuant to section 173.785169.08 of 37194
the Revised Code;37195

       (2) Information disclosed in a manufacturer agreement entered 37196
into under section 173.815169.11 of the Revised Code or in 37197
communications related to an agreement;37198

       (3) Drug pricing and drug manufacturer payment information 37199
verified under sections 173.7425169.042 and 173.8145169.114 of 37200
the Revised Code by the program's consulting pharmacy benefit 37201
manager selected under section 173.7315169.031 of the Revised 37202
Code;37203

       (4) Information contained in or pertaining to an audit 37204
provided for by the program's consulting pharmacy benefit manager 37205
under section 173.7325169.032 of the Revised Code;37206

       (5) The elements of the computations made pursuant to 37207
sections 173.755169.05, 173.8015169.101, and 173.8125169.112 of 37208
the Revised Code and any results of those computations that reveal 37209
or could be used to reveal the manufacturer payment amounts used 37210
to make the computations.37211

       (B) No person or government entity shall use or reveal any 37212
information specified in division (A) of this section except as 37213
required for the implementation of sections 173.715169.01 to 37214
173.915169.21 of the Revised Code.37215

       Sec. 173.892.        Sec. 5169.192.  Sections 173.895169.19 and 173.89137216
5169.191 of the Revised Code shall not preclude the department of 37217
aginghealth care administration from disclosing information 37218
necessary for the implementation of sections 173.715169.01 to 37219
173.915169.21 of the Revised Code, including the amount an Ohio's 37220
best Rx program participant is to be charged when the amount is 37221
disclosed under section 173.7515169.051 of the Revised Code to 37222
participating terminal distributors or the drug mail order system 37223
included in the program pursuant to section 173.785169.08 of the 37224
Revised Code.37225

       Sec. 173.90.        Sec. 5169.20. (A) As used in this section, 37226
"identifying information" means information that identifies or 37227
could be used to identify an Ohio's best Rx program applicant or 37228
participant. "Identifying information" does not include aggregate 37229
information about applicants and participants that does not 37230
identify and could not be used to identify an individual applicant 37231
or participant.37232

        (B) Except as provided in divisions (C), (D), and (E) of this 37233
section, no person or government entity shall sell, solicit, 37234
disclose, receive, or use identifying information or knowingly 37235
permit the use of identifying information.37236

       (C)(1) The department of aginghealth care administration may 37237
solicit, disclose, receive, or use identifying information or 37238
knowingly permit the use of identifying information for a purpose 37239
directly connected to the administration of the Ohio's best Rx 37240
program, including disclosing and knowingly permitting the use of 37241
identifying information included in a claim that a participating 37242
manufacturer audits pursuant to section 173.825169.12 of the 37243
Revised Code, contacting Ohio's best Rx program applicants or 37244
participants regarding participation in the program, and notifying 37245
applicants and participants regarding participating terminal 37246
distributors and the drug mail order system included in the 37247
program pursuant to section 173.785169.08 of the Revised Code.37248

        (2) The department may solicit, disclose, receive, or use 37249
identifying information or knowingly permit the use of identifying 37250
information to the extent required by federal law.37251

        (3) The department may disclose identifying information to 37252
the Ohio's best Rx program applicant or participant who is the 37253
subject of that information or to the parent, spouse, guardian, or 37254
custodian of that applicant or participant.37255

        (D)(1) A participating terminal distributor may solicit, 37256
disclose, receive, or use identifying information or knowingly 37257
permit the use of identifying information to the extent required 37258
or permitted by an agreement the distributor enters into under 37259
section 173.795169.09 of the Revised Code.37260

       (2) Subject to division (B) of section 173.785169.08 of the 37261
Revised Code, the drug mail order system included in the program 37262
pursuant to section 173.785169.08 of the Revised Code may 37263
solicit, disclose, receive, or use identifying information or 37264
knowingly permit the use of identifying information to the extent 37265
required or permitted by the department.37266

        (E) A participating manufacturer may, for the purpose of 37267
auditing a claim pursuant to section 173.825169.12 of the Revised 37268
Code, solicit, receive, and use identifying information included 37269
in the claim.37270

       Sec. 173.91.        Sec. 5169.21.  (A) Except as provided in division (B) 37271
of this section, the department of aginghealth care 37272
administration shall use and preserve records regarding the Ohio's 37273
best Rx program in accordance with rules adopted under section 37274
173.835169.13 of the Revised Code. The department shall use and 37275
preserve the records in accordance with those rules, regardless of 37276
whether the department generated the records or received them from 37277
another government entity or any person.37278

       (B) All records received by the department under sections 37279
173.7425169.042 and 173.8145169.114 of the Revised Code from the 37280
program's consulting pharmacy benefit manager selected under 37281
section 173.7315169.031 of the Revised Code shall be destroyed 37282
promptly after the department has completed the purpose for which 37283
the information contained in the records was obtained.37284

       Sec. 5169.99.  Whoever violates division (B) of section 37285
5169.20 of the Revised Code is guilty of a misdemeanor of the 37286
first degree.37287

       Sec. 5302.221. (A) As used in this section:37288

       "Estate" has the same meaning as in section 5111.115162.4037289
of the Revised Code.37290

       "Medicaid estate recovery program" means the program 37291
instituted under section 5111.115162.40 of the Revised Code.37292

       (B) The administrator of the medicaid estate recovery program 37293
shall prescribe a form on which a beneficiary of a transfer on 37294
death deed as provided in section 5302.22 of the Revised Code, who 37295
survives the deceased owner of the real property or an interest in 37296
the real property or that is in existence on the date of death of 37297
the deceased owner, or such a beneficiary's representative is to 37298
indicate both of the following:37299

       (1) Whether the deceased owner was either of the following:37300

       (a) A decedent subject to the medicaid estate recovery 37301
program;37302

       (b) The spouse of a decedent subject to the medicaid estate 37303
recovery program.37304

       (2) Whether the real property or interest in the real 37305
property was part of the estate of a decedent subject to the 37306
medicaid estate recovery program.37307

       (C) A county recorder shall obtain a properly completed form 37308
prescribed under division (B) of this section from the beneficiary 37309
of a transfer on death deed or the beneficiary's representative 37310
and send a copy of the form to the administrator of the medicaid 37311
estate recovery program before recording the transfer of the real 37312
property or interest in the real property under division (C) of 37313
section 5302.22 of the Revised Code.37314

       Sec. 5309.082. (A) As used in this section:37315

       "Estate" has the same meaning as in section 5111.115162.4037316
of the Revised Code.37317

       "Medicaid estate recovery program" means the program 37318
instituted under section 5111.115162.40 of the Revised Code.37319

       (B) The administrator of the medicaid estate recovery program 37320
shall prescribe a form on which a surviving tenant under a 37321
survivorship tenancy or such a surviving tenant's representative 37322
is to indicate both of the following:37323

       (1) Whether the deceased survivorship tenant was either of 37324
the following:37325

       (a) A decedent subject to the medicaid estate recovery 37326
program;37327

       (b) The spouse of a decedent subject to the medicaid estate 37328
recovery program.37329

       (2) Whether the registered land under a survivorship tenancy 37330
was part of the estate of a decedent subject to the medicaid 37331
estate recovery program.37332

       (C) A county recorder shall obtain a properly completed form 37333
prescribed under division (B) of this section from the surviving 37334
tenant under a survivorship tenancy or the surviving tenant's 37335
representative and send a copy of the form to the administrator of 37336
the medicaid estate recovery program before registering the title 37337
in the surviving tenants under section 5309.081 of the Revised 37338
Code.37339

       Sec. 5505.04.  (A)(1) The general administration and37340
management of the state highway patrol retirement system and the37341
making effective of this chapter are hereby vested in the state37342
highway patrol retirement board. The board may sue and be sued,37343
plead and be impleaded, contract and be contracted with, and do37344
all things necessary to carry out this chapter.37345

       The board shall consist of the following members:37346

       (a) The superintendent of the state highway patrol;37347

       (b) Two retirant members who reside in this state;37348

       (c) Five employee-members;37349

       (d) One member, known as the treasurer of state's investment 37350
designee, who shall be appointed by the treasurer of state for a 37351
term of four years and who shall have the following 37352
qualifications:37353

       (i) The member is a resident of this state.37354

       (ii) Within the three years immediately preceding the 37355
appointment, the member has not been employed by the public 37356
employees retirement system, police and fire pension fund, state 37357
teachers retirement system, school employees retirement system, or 37358
state highway patrol retirement system or by any person, 37359
partnership, or corporation that has provided to one of those 37360
retirement systems services of a financial or investment nature, 37361
including the management, analysis, supervision, or investment of 37362
assets.37363

       (iii) The member has direct experience in the management, 37364
analysis, supervision, or investment of assets.37365

       (iv) The member is not currently employed by the state or a 37366
political subdivision of the state.37367

        (e) Two investment expert members, who shall be appointed to 37368
four-year terms. One investment expert member shall be appointed 37369
by the governor, and one investment expert member shall be jointly 37370
appointed by the speaker of the house of representatives and the 37371
president of the senate. Each investment expert member shall have 37372
the following qualifications:37373

       (i) Each investment expert member shall be a resident of this 37374
state.37375

       (ii) Within the three years immediately preceding the 37376
appointment, each investment expert member shall not have been 37377
employed by the public employees retirement system, police and 37378
fire pension fund, state teachers retirement system, school 37379
employees retirement system, or state highway patrol retirement 37380
system or by any person, partnership, or corporation that has 37381
provided to one of those retirement systems services of a 37382
financial or investment nature, including the management, 37383
analysis, supervision, or investment of assets.37384

       (iii) Each investment expert member shall have direct 37385
experience in the management, analysis, supervision, or investment 37386
of assets.37387

       (2) The board shall annually elect a chairperson and37388
vice-chairperson from among its members. The vice-chairperson37389
shall act as chairperson in the absence of the chairperson. A37390
majority of the members of the board shall constitute a quorum and37391
any action taken shall be approved by a majority of the members of 37392
the board. The board shall meet not less than once each year, upon 37393
sufficient notice to the members. All meetings of the board shall 37394
be open to the public except executive sessions as set forth in 37395
division (G) of section 121.22 of the Revised Code, and any 37396
portions of any sessions discussing medical records or the degree 37397
of disability of a member excluded from public inspection by this 37398
section.37399

       (3) Any investment expert member appointed to fill a vacancy 37400
occurring prior to the expiration of the term for which the 37401
member's predecessor was appointed holds office until the end of 37402
such term. The member continues in office subsequent to the 37403
expiration date of the member's term until the member's successor 37404
takes office, or until a period of sixty days has elapsed, 37405
whichever occurs first.37406

       (B) The attorney general shall prescribe procedures for the37407
adoption of rules authorized under this chapter, consistent with37408
the provision of section 111.15 of the Revised Code under which37409
all rules shall be filed in order to be effective. Such procedures 37410
shall establish methods by which notice of proposed rules are 37411
given to interested parties and rules adopted by the board 37412
published and otherwise made available. When it files a rule with 37413
the joint committee on agency rule review pursuant to section 37414
111.15 of the Revised Code, the board shall submit to the Ohio 37415
retirement study council a copy of the full text of the rule, and 37416
if applicable, a copy of the rule summary and fiscal analysis37417
required by division (B) of section 127.18 of the Revised Code.37418

       (C)(1) As used in this division, "personal history record"37419
means information maintained by the board on an individual who is37420
a member, former member, retirant, or beneficiary that includes37421
the address, telephone number, social security number, record of37422
contributions, correspondence with the system, and other37423
information the board determines to be confidential.37424

       (2) The records of the board shall be open to public37425
inspection, except for the following which shall be excluded: the37426
member's, former member's, retirant's, or beneficiary's personal37427
history record and the amount of a monthly allowance or benefit37428
paid to a retirant, beneficiary, or survivor, except with the37429
written authorization of the individual concerned. All medical37430
reports and recommendations are privileged except that copies of37431
such medical reports or recommendations shall be made available to37432
the individual's personal physician, attorney, or authorized agent37433
upon written release received from such individual or such37434
individual's agent, or when necessary for the proper37435
administration of the fund to the board-assigned physician.37436

       (D) Notwithstanding the exceptions to public inspection in37437
division (C)(2) of this section, the board may furnish the37438
following information:37439

       (1) If a member, former member, or retirant is subject to an37440
order issued under section 2907.15 of the Revised Code or an order 37441
issued under division (A) or (B) of section 2929.192 of the 37442
Revised Code or is convicted of or pleads guilty to a violation of 37443
section 2921.41 of the Revised Code, on written request of a 37444
prosecutor as defined in section 2935.01 of the Revised Code, the 37445
board shall furnish to the prosecutor the information requested 37446
from the individual's personal history record.37447

       (2) Pursuant to a court order issued under Chapters 3119.,37448
3121., and 3123. of the Revised Code, the board shall furnish to a37449
court or child support enforcement agency the information required37450
under those chapters.37451

       (3) At the written request of any nonprofit organization or37452
association providing services to retirement system members,37453
retirants, or beneficiaries, the board shall provide to the37454
organization or association a list of the names and addresses of37455
members, former members, retirants, or beneficiaries if the37456
organization or association agrees to use such information solely37457
in accordance with its stated purpose of providing services to37458
such individuals and not for the benefit of other persons,37459
organizations, or associations. The costs of compiling, copying,37460
and mailing the list shall be paid by such entity.37461

       (4) Within fourteen days after receiving from the director of 37462
job and family services a list of the names and social security37463
numbers of recipients of public assistance pursuant to section37464
5101.181 of the Revised Code or a list of the names and social 37465
security numbers of public medical assistance recipients pursuant 37466
to section 5160.43 of the Revised Code, the board shall inform the 37467
auditor of state of the name, current or most recent employer 37468
address, and social security number of each member whose name and 37469
social security number are the same as those of a person whose 37470
name or social security number was submitted by the directoris 37471
included on the list. The board and its employees, except for 37472
purposes of furnishing the auditor of state with information 37473
required by this section, shall preserve the confidentiality of 37474
recipients of public assistance in compliance with division (A) of37475
section 5101.181 of the Revised Code and preserve the 37476
confidentiality of public medical assistance program recipients in 37477
compliance with section 5160.43 of the Revised Code.37478

       (5) The system shall comply with orders issued under section37479
3105.87 of the Revised Code.37480

       On the written request of an alternate payee, as defined in37481
section 3105.80 of the Revised Code, the system shall furnish to37482
the alternate payee information on the amount and status of any37483
amounts payable to the alternate payee under an order issued under37484
section 3105.171 or 3105.65 of the Revised Code.37485

       (6) At the request of any person, the board shall make 37486
available to the person copies of all documents, including 37487
resumes, in the board's possession regarding filling a vacancy of 37488
an employee member or retirant member of the board. The person who 37489
made the request shall pay the cost of compiling, copying, and 37490
mailing the documents. The information described in this division 37491
is a public record.37492

       (E) A statement that contains information obtained from the37493
system's records that is certified and signed by an officer of the37494
retirement system and to which the system's official seal is37495
affixed, or copies of the system's records to which the signature37496
and seal are attached, shall be received as true copies of the37497
system's records in any court or before any officer of this state.37498

       Sec. 5725.18.  (A) An annual franchise tax on the privilege 37499
of being an insurance company is hereby levied on each domestic37500
insurance company. In the month of May, annually, the treasurer of 37501
state shall charge for collection from each domestic insurance37502
company a franchise tax in the amount computed in accordance with37503
the following, as applicable:37504

       (1) With respect to a domestic insurance company that is a 37505
health insuring corporation, one per cent of all premium rate 37506
payments received, exclusive of payments received under the 37507
medicare program established under Title XVIII of the "Social37508
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,37509
or pursuant to the medical assistancemedicaid program established 37510
under Chapter 5111. of the Revised Code, as reflected in its 37511
annual report for the preceding calendar year;37512

       (2) With respect to a domestic insurance company that is not 37513
a health insuring corporation, one and four-tenths per cent of the37514
gross amount of premiums received from policies covering risks 37515
within this state, exclusive of premiums received under the 37516
medicare program established under Title XVIII of the "Social37517
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,37518
or pursuant to the medical assistancemedicaid program established 37519
under Chapter 5111. of the Revised Code, as reflected in its 37520
annual statement for the preceding calendar year, and, if the 37521
company operates a health insuring corporation as a line of 37522
business, one per cent of all premium rate payments received from 37523
that line of business, exclusive of payments received under the 37524
medicare program established under Title XVIII of the "Social 37525
Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,37526
or pursuant to the medical assistancemedicaid program established 37527
under Chapter 5111. of the Revised Code, as reflected in its37528
annual statement for the preceding calendar year.37529

       (B) The gross amount of premium rate payments or premiums 37530
used to compute the applicable tax in accordance with division (A)37531
of this section is subject to the deductions prescribed by section37532
5729.03 of the Revised Code for foreign insurance companies. The37533
objects of such tax are those declared in section 5725.24 of the37534
Revised Code, to which only such tax shall be applied.37535

       (C) In no case shall such tax be less than two hundred fifty 37536
dollars.37537

       Sec. 5729.03.  (A) If the superintendent of insurance finds 37538
the annual statement required by section 5729.02 of the Revised 37539
Code to be correct, the superintendent shall compute the following 37540
amount, as applicable, of the balance of such gross amount, after 37541
deducting such return premiums and considerations received for 37542
reinsurance, and charge such amount to such company as a tax upon 37543
the business done by it in this state for the period covered by 37544
such annual statement:37545

       (1) If the company is a health insuring corporation, one per 37546
cent of the balance of premium rate payments received, exclusive 37547
of payments received under the medicare program established under 37548
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 37549
U.S.C.A. 301, as amended, or pursuant to the medical assistance37550
medicaid program established under Chapter 5111. of the Revised 37551
Code, as reflected in its annual report;37552

       (2) If the company is not a health insuring corporation, one 37553
and four-tenths per cent of the balance of premiums received,37554
exclusive of premiums received under the medicare program 37555
established under Title XVIII of the "Social Security Act," 4937556
Stat. 620 (1935), 42 U.S.C.A. 301, as amended, or pursuant to the 37557
medical assistancemedicaid program established under Chapter 37558
5111. of the Revised Code, as reflected in its annual statement, 37559
and, if the company operates a health insuring corporation as a 37560
line of business, one per cent of the balance of premium rate 37561
payments received from that line of business, exclusive of37562
payments received under the medicare program established under37563
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 4237564
U.S.C.A. 301, as amended, or pursuant to the medical assistance37565
medicaid program established under Chapter 5111. of the Revised 37566
Code, as reflected in its annual statement.37567

       (B) Any insurance policies that were not issued in violation 37568
of Title XXXIX of the Revised Code and that were issued prior to 37569
April 15, 1967, by a life insurance company organized and operated 37570
without profit to any private shareholder or individual, 37571
exclusively for the purpose of aiding educational or scientific 37572
institutions organized and operated without profit to any private 37573
shareholder or individual, are not subject to the tax imposed by 37574
this section. All taxes collected pursuant to this section shall 37575
be credited to the general revenue fund.37576

       (C) In no case shall the tax imposed under this section be 37577
less than two hundred fifty dollars.37578

       Sec. 5731.39.  (A) No corporation organized or existing under 37579
the laws of this state shall transfer on its books or issue a new 37580
certificate for any share of its capital stock registered in the 37581
name of a decedent, or in trust for a decedent, or in the name of 37582
a decedent and another person or persons, without the written 37583
consent of the tax commissioner.37584

       (B) No safe deposit company, trust company, financial37585
institution as defined in division (A) of section 5725.01 of the37586
Revised Code or other corporation or person, having in possession, 37587
control, or custody a deposit standing in the name of a decedent, 37588
or in trust for a decedent, or in the name of a decedent and 37589
another person or persons, shall deliver or transfer an amount in 37590
excess of three-fourths of the total value of such deposit, 37591
including accrued interest and dividends, as of the date of 37592
decedent's death, without the written consent of the tax37593
commissioner. The written consent of the tax commissioner need not 37594
be obtained prior to the delivery or transfer of amounts having a 37595
value of three-fourths or less of said total value.37596

       (C) No life insurance company shall pay the proceeds of an37597
annuity or matured endowment contract, or of a life insurance37598
contract payable to the estate of a decedent, or of any other37599
insurance contract taxable under Chapter 5731. of the Revised37600
Code, without the written consent of the tax commissioner. Any37601
life insurance company may pay the proceeds of any insurance37602
contract not specified in this division (C) without the written37603
consent of the tax commissioner.37604

       (D) No trust company or other corporation or person shall pay 37605
the proceeds of any death benefit, retirement, pension or profit 37606
sharing plan in excess of two thousand dollars, without the 37607
written consent of the tax commissioner. Such trust company or 37608
other corporation or person, however, may pay the proceeds of any 37609
death benefit, retirement, pension, or profit-sharing plan which 37610
consists of insurance on the life of the decedent payable to a 37611
beneficiary other than the estate of the insured without the37612
written consent of the tax commissioner.37613

       (E) No safe deposit company, trust company, financial37614
institution as defined in division (A) of section 5725.01 of the37615
Revised Code, or other corporation or person, having in37616
possession, control, or custody securities, assets, or other37617
property (including the shares of the capital stock of, or other37618
interest in, such safe deposit company, trust company, financial37619
institution as defined in division (A) of section 5725.01 of the37620
Revised Code, or other corporation), standing in the name of a37621
decedent, or in trust for a decedent, or in the name of a decedent 37622
and another person or persons, and the transfer of which is 37623
taxable under Chapter 5731. of the Revised Code, shall deliver or 37624
transfer any such securities, assets, or other property which have 37625
a value as of the date of decedent's death in excess of37626
three-fourths of the total value thereof, without the written37627
consent of the tax commissioner. The written consent of the tax37628
commissioner need not be obtained prior to the delivery or37629
transfer of any such securities, assets, or other property having37630
a value of three-fourths or less of said total value.37631

       (F) No safe deposit company, financial institution as defined 37632
in division (A) of section 5725.01 of the Revised Code, or other 37633
corporation or person having possession or control of a safe 37634
deposit box or similar receptacle standing in the name of a37635
decedent or in the name of the decedent and another person or37636
persons, or to which the decedent had a right of access, except37637
when such safe deposit box or other receptacle stands in the name37638
of a corporation or partnership, or in the name of the decedent as 37639
guardian or executor, shall deliver any of the contents thereof 37640
unless the safe deposit box or similar receptacle has been opened 37641
and inventoried in the presence of the tax commissioner or the 37642
commissioner's agent, and a written consent to transfer issued; 37643
provided, however, that a safe deposit company, financial37644
institution, or other corporation or person having possession or37645
control of a safe deposit box may deliver wills, deeds to burial37646
lots, and insurance policies to a representative of the decedent,37647
but that a representative of the safe deposit company, financial37648
institution, or other corporation or person must supervise the37649
opening of the box and make a written record of the wills, deeds,37650
and policies removed. Such written record shall be included in the 37651
tax commissioner's inventory records.37652

       (G) Notwithstanding any provision of this section:37653

       (1) The tax commissioner may authorize any delivery or 37654
transfer or waive any of the foregoing requirements under such 37655
terms and conditions as the commissioner may prescribe;37656

       (2) An adult care facility, as defined in section 3722.01 of 37657
the Revised Code, or a home, as defined in section 3721.10 of the 37658
Revised Code, may transfer or use the money in a personal needs 37659
allowance account in accordance with section 5111.1135162.37 of 37660
the Revised Code without the written consent of the tax 37661
commissioner, and without the account having been opened and 37662
inventoried in the presence of the commissioner or the37663
commissioner's agent. 37664

       Failure to comply with this section shall render such safe 37665
deposit company, trust company, life insurance company, financial 37666
institution as defined in division (A) of section 5725.01 of the 37667
Revised Code, or other corporation or person liable for the amount 37668
of the taxes and interest due under the provisions of Chapter 37669
5731. of the Revised Code on the transfer of such stock, deposit, 37670
proceeds of an annuity or matured endowment contract or of a life 37671
insurance contract payable to the estate of a decedent, or other 37672
insurance contract taxable under Chapter 5731. of the Revised 37673
Code, proceeds of any death benefit, retirement, pension, or 37674
profit sharing plan in excess of two thousand dollars, or 37675
securities, assets, or other property of any resident decedent, 37676
and in addition thereto, to a penalty of not less than five 37677
hundred or more than five thousand dollars.37678

       Sec. 5747.01.  Except as otherwise expressly provided or37679
clearly appearing from the context, any term used in this chapter 37680
that is not otherwise defined in this section has the same meaning 37681
as when used in a comparable context in the laws of the United37682
States relating to federal income taxes or if not used in a 37683
comparable context in those laws, has the same meaning as in 37684
section 5733.40 of the Revised Code. Any reference in this chapter 37685
to the Internal Revenue Code includes other laws of the United 37686
States relating to federal income taxes.37687

       As used in this chapter:37688

       (A) "Adjusted gross income" or "Ohio adjusted gross income"37689
means federal adjusted gross income, as defined and used in the37690
Internal Revenue Code, adjusted as provided in this section:37691

       (1) Add interest or dividends on obligations or securities of 37692
any state or of any political subdivision or authority of any37693
state, other than this state and its subdivisions and authorities.37694

       (2) Add interest or dividends on obligations of any37695
authority, commission, instrumentality, territory, or possession37696
of the United States to the extent that the interest or dividends37697
are exempt from federal income taxes but not from state income37698
taxes.37699

       (3) Deduct interest or dividends on obligations of the United 37700
States and its territories and possessions or of any authority, 37701
commission, or instrumentality of the United States to the extent37702
that the interest or dividends are included in federal adjusted 37703
gross income but exempt from state income taxes under the laws of 37704
the United States.37705

       (4) Deduct disability and survivor's benefits to the extent37706
included in federal adjusted gross income.37707

       (5) Deduct benefits under Title II of the Social Security Act 37708
and tier 1 railroad retirement benefits to the extent included in 37709
federal adjusted gross income under section 86 of the Internal37710
Revenue Code.37711

       (6) In the case of a taxpayer who is a beneficiary of a trust 37712
that makes an accumulation distribution as defined in section 665 37713
of the Internal Revenue Code, add, for the beneficiary's taxable 37714
years beginning before 2002, the portion, if any, of such 37715
distribution that does not exceed the undistributed net income of 37716
the trust for the three taxable years preceding the taxable year 37717
in which the distribution is made to the extent that the portion 37718
was not included in the trust's taxable income for any of the 37719
trust's taxable years beginning in 2002 or thereafter.37720
"Undistributed net income of a trust" means the taxable income of37721
the trust increased by (a)(i) the additions to adjusted gross37722
income required under division (A) of this section and (ii) the37723
personal exemptions allowed to the trust pursuant to section37724
642(b) of the Internal Revenue Code, and decreased by (b)(i) the37725
deductions to adjusted gross income required under division (A) of37726
this section, (ii) the amount of federal income taxes attributable37727
to such income, and (iii) the amount of taxable income that has37728
been included in the adjusted gross income of a beneficiary by37729
reason of a prior accumulation distribution. Any undistributed net37730
income included in the adjusted gross income of a beneficiary37731
shall reduce the undistributed net income of the trust commencing37732
with the earliest years of the accumulation period.37733

       (7) Deduct the amount of wages and salaries, if any, not37734
otherwise allowable as a deduction but that would have been37735
allowable as a deduction in computing federal adjusted gross37736
income for the taxable year, had the targeted jobs credit allowed37737
and determined under sections 38, 51, and 52 of the Internal37738
Revenue Code not been in effect.37739

       (8) Deduct any interest or interest equivalent on public37740
obligations and purchase obligations to the extent that the37741
interest or interest equivalent is included in federal adjusted37742
gross income.37743

       (9) Add any loss or deduct any gain resulting from the sale,37744
exchange, or other disposition of public obligations to the extent37745
that the loss has been deducted or the gain has been included in37746
computing federal adjusted gross income.37747

       (10) Deduct or add amounts, as provided under section37748
5747.70 of the Revised Code, related to contributions to variable37749
college savings program accounts made or tuition units purchased37750
pursuant to Chapter 3334. of the Revised Code.37751

       (11)(a) Deduct, to the extent not otherwise allowable as a37752
deduction or exclusion in computing federal or Ohio adjusted gross37753
income for the taxable year, the amount the taxpayer paid during37754
the taxable year for medical care insurance and qualified37755
long-term care insurance for the taxpayer, the taxpayer's spouse,37756
and dependents. No deduction for medical care insurance under37757
division (A)(11) of this section shall be allowed either to any37758
taxpayer who is eligible to participate in any subsidized health37759
plan maintained by any employer of the taxpayer or of the37760
taxpayer's spouse, or to any taxpayer who is entitled to, or on37761
application would be entitled to, benefits under part A of Title37762
XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.37763
301, as amendedmedicare program. For the purposes of division 37764
(A)(11)(a) of this section, "subsidized health plan" means a 37765
health plan for which the employer pays any portion of the plan's 37766
cost. The deduction allowed under division (A)(11)(a) of this 37767
section shall be the net of any related premium refunds, related 37768
premium reimbursements, or related insurance premium dividends 37769
received during the taxable year.37770

       (b) Deduct, to the extent not otherwise deducted or excluded37771
in computing federal or Ohio adjusted gross income during the37772
taxable year, the amount the taxpayer paid during the taxable37773
year, not compensated for by any insurance or otherwise, for37774
medical care of the taxpayer, the taxpayer's spouse, and37775
dependents, to the extent the expenses exceed seven and one-half37776
per cent of the taxpayer's federal adjusted gross income.37777

       (c) For purposes of division (A)(11) of this section,37778
"medical care" has the meaning given in section 213 of the37779
Internal Revenue Code, subject to the special rules, limitations,37780
and exclusions set forth therein, and "qualified long-term care"37781
has the same meaning given in section 7702B(c) of the Internal37782
Revenue Code.37783

       (12)(a) Deduct any amount included in federal adjusted gross37784
income solely because the amount represents a reimbursement or37785
refund of expenses that in any year the taxpayer had deducted as37786
an itemized deduction pursuant to section 63 of the Internal37787
Revenue Code and applicable United States department of the37788
treasury regulations. The deduction otherwise allowed under37789
division (A)(12)(a) of this section shall be reduced to the extent37790
the reimbursement is attributable to an amount the taxpayer37791
deducted under this section in any taxable year.37792

       (b) Add any amount not otherwise included in Ohio adjusted37793
gross income for any taxable year to the extent that the amount is37794
attributable to the recovery during the taxable year of any amount37795
deducted or excluded in computing federal or Ohio adjusted gross37796
income in any taxable year.37797

       (13) Deduct any portion of the deduction described in section 37798
1341(a)(2) of the Internal Revenue Code, for repaying previously 37799
reported income received under a claim of right, that meets both 37800
of the following requirements:37801

       (a) It is allowable for repayment of an item that was37802
included in the taxpayer's adjusted gross income for a prior37803
taxable year and did not qualify for a credit under division (A)37804
or (B) of section 5747.05 of the Revised Code for that year;37805

       (b) It does not otherwise reduce the taxpayer's adjusted37806
gross income for the current or any other taxable year.37807

       (14) Deduct an amount equal to the deposits made to, and net37808
investment earnings of, a medical savings account during the37809
taxable year, in accordance with section 3924.66 of the Revised37810
Code. The deduction allowed by division (A)(14) of this section37811
does not apply to medical savings account deposits and earnings37812
otherwise deducted or excluded for the current or any other37813
taxable year from the taxpayer's federal adjusted gross income.37814

       (15)(a) Add an amount equal to the funds withdrawn from a37815
medical savings account during the taxable year, and the net37816
investment earnings on those funds, when the funds withdrawn were37817
used for any purpose other than to reimburse an account holder37818
for, or to pay, eligible medical expenses, in accordance with37819
section 3924.66 of the Revised Code;37820

       (b) Add the amounts distributed from a medical savings37821
account under division (A)(2) of section 3924.68 of the Revised37822
Code during the taxable year.37823

       (16) Add any amount claimed as a credit under section37824
5747.059 of the Revised Code to the extent that such amount37825
satisfies either of the following:37826

       (a) The amount was deducted or excluded from the computation37827
of the taxpayer's federal adjusted gross income as required to be37828
reported for the taxpayer's taxable year under the Internal37829
Revenue Code;37830

       (b) The amount resulted in a reduction of the taxpayer's37831
federal adjusted gross income as required to be reported for any37832
of the taxpayer's taxable years under the Internal Revenue Code.37833

       (17) Deduct the amount contributed by the taxpayer to an37834
individual development account program established by a county37835
department of job and family services pursuant to sections 329.1137836
to 329.14 of the Revised Code for the purpose of matching funds37837
deposited by program participants. On request of the tax37838
commissioner, the taxpayer shall provide any information that, in37839
the tax commissioner's opinion, is necessary to establish the37840
amount deducted under division (A)(17) of this section.37841

       (18) Beginning in taxable year 2001 but not for any taxable 37842
year beginning after December 31, 2005, if the taxpayer is married37843
and files a joint return and the combined federal adjusted gross 37844
income of the taxpayer and the taxpayer's spouse for the taxable 37845
year does not exceed one hundred thousand dollars, or if the 37846
taxpayer is single and has a federal adjusted gross income for the37847
taxable year not exceeding fifty thousand dollars, deduct amounts 37848
paid during the taxable year for qualified tuition and fees paid 37849
to an eligible institution for the taxpayer, the taxpayer's 37850
spouse, or any dependent of the taxpayer, who is a resident of 37851
this state and is enrolled in or attending a program that37852
culminates in a degree or diploma at an eligible institution. The 37853
deduction may be claimed only to the extent that qualified tuition 37854
and fees are not otherwise deducted or excluded for any taxable 37855
year from federal or Ohio adjusted gross income. The deduction may 37856
not be claimed for educational expenses for which the taxpayer 37857
claims a credit under section 5747.27 of the Revised Code.37858

       (19) Add any reimbursement received during the taxable year37859
of any amount the taxpayer deducted under division (A)(18) of this37860
section in any previous taxable year to the extent the amount is37861
not otherwise included in Ohio adjusted gross income.37862

       (20)(a)(i) Add five-sixths of the amount of depreciation37863
expense allowed by subsection (k) of section 168 of the Internal37864
Revenue Code, including the taxpayer's proportionate or37865
distributive share of the amount of depreciation expense allowed37866
by that subsection to a pass-through entity in which the taxpayer37867
has a direct or indirect ownership interest.37868

       (ii) Add five-sixths of the amount of qualifying section 179 37869
depreciation expense, including a person's proportionate or 37870
distributive share of the amount of qualifying section 179 37871
depreciation expense allowed to any pass-through entity in which 37872
the person has a direct or indirect ownership. For the purposes of 37873
this division, "qualifying section 179 depreciation expense" means 37874
the difference between (I) the amount of depreciation expense 37875
directly or indirectly allowed to the taxpayer under section 179 37876
of the Internal Revenue Code, and (II) the amount of depreciation 37877
expense directly or indirectly allowed to the taxpayer under 37878
section 179 of the Internal Revenue Code as that section existed 37879
on December 31, 2002.37880

       The tax commissioner, under procedures established by the 37881
commissioner, may waive the add-backs related to a pass-through 37882
entity if the taxpayer owns, directly or indirectly, less than 37883
five per cent of the pass-through entity.37884

       (b) Nothing in division (A)(20) of this section shall be37885
construed to adjust or modify the adjusted basis of any asset.37886

       (c) To the extent the add-back required under division37887
(A)(20)(a) of this section is attributable to property generating37888
nonbusiness income or loss allocated under section 5747.20 of the37889
Revised Code, the add-back shall be sitused to the same location37890
as the nonbusiness income or loss generated by the property for37891
the purpose of determining the credit under division (A) of37892
section 5747.05 of the Revised Code. Otherwise, the add-back shall 37893
be apportioned, subject to one or more of the four alternative 37894
methods of apportionment enumerated in section 5747.21 of the 37895
Revised Code.37896

       (d) For the purposes of division (A) of this section, net 37897
operating loss carryback and carryforward shall not include 37898
five-sixths of the allowance of any net operating loss deduction 37899
carryback or carryforward to the taxable year to the extent such 37900
loss resulted from depreciation allowed by section 168(k) of the 37901
Internal Revenue Code and by the qualifying section 179 37902
depreciation expense amount.37903

       (21)(a) If the taxpayer was required to add an amount under37904
division (A)(20)(a) of this section for a taxable year, deduct37905
one-fifth of the amount so added for each of the five succeeding37906
taxable years.37907

       (b) If the amount deducted under division (A)(21)(a) of this37908
section is attributable to an add-back allocated under division37909
(A)(20)(c) of this section, the amount deducted shall be sitused37910
to the same location. Otherwise, the add-back shall be apportioned 37911
using the apportionment factors for the taxable year in which the 37912
deduction is taken, subject to one or more of the four alternative 37913
methods of apportionment enumerated in section 5747.21 of the 37914
Revised Code.37915

       (c) No deduction is available under division (A)(21)(a) of 37916
this section with regard to any depreciation allowed by section 37917
168(k) of the Internal Revenue Code and by the qualifying section 37918
179 depreciation expense amount to the extent that such 37919
depreciation resulted in or increased a federal net operating loss 37920
carryback or carryforward to a taxable year to which division 37921
(A)(20)(d) of this section does not apply.37922

       (22) Deduct, to the extent not otherwise deducted or excluded 37923
in computing federal or Ohio adjusted gross income for the taxable 37924
year, the amount the taxpayer received during the taxable year as 37925
reimbursement for life insurance premiums under section 5919.31 of 37926
the Revised Code.37927

        (23) Deduct, to the extent not otherwise deducted or excluded 37928
in computing federal or Ohio adjusted gross income for the taxable 37929
year, the amount the taxpayer received during the taxable year as 37930
a death benefit paid by the adjutant general under section 5919.33 37931
of the Revised Code.37932

       (24) Deduct, to the extent included in federal adjusted gross 37933
income and not otherwise allowable as a deduction or exclusion in 37934
computing federal or Ohio adjusted gross income for the taxable 37935
year, military pay and allowances received by the taxpayer during 37936
the taxable year for active duty service in the United States 37937
army, air force, navy, marine corps, or coast guard or reserve 37938
components thereof or the national guard. The deduction may not be 37939
claimed for military pay and allowances received by the taxpayer 37940
while the taxpayer is stationed in this state.37941

       (25) Deduct, to the extent not otherwise allowable as a 37942
deduction or exclusion in computing federal or Ohio adjusted gross 37943
income for the taxable year and not otherwise compensated for by 37944
any other source, the amount of qualified organ donation expenses 37945
incurred by the taxpayer during the taxable year, not to exceed 37946
ten thousand dollars. A taxpayer may deduct qualified organ 37947
donation expenses only once for all taxable years beginning with 37948
taxable years beginning in 2007.37949

       For the purposes of division (A)(25) of this section:37950

        (a) "Human organ" means all or any portion of a human liver, 37951
pancreas, kidney, intestine, or lung, and any portion of human 37952
bone marrow.37953

        (b) "Qualified organ donation expenses" means travel 37954
expenses, lodging expenses, and wages and salary forgone by a 37955
taxpayer in connection with the taxpayer's donation, while living, 37956
of one or more of the taxpayer's human organs to another human 37957
being.37958

       (26) Deduct, to the extent not otherwise deducted or excluded 37959
in computing federal or Ohio adjusted gross income for the taxable 37960
year, amounts received by the taxpayer as retired military 37961
personnel pay for service in the United States army, navy, air 37962
force, coast guard, or marine corps or reserve components thereof, 37963
or the national guard, or received by the surviving spouse or 37964
former spouse of such a taxpayer under the survivor benefit plan 37965
on account of such a taxpayer's death. If the taxpayer receives 37966
income on account of retirement paid under the federal civil 37967
service retirement system or federal employees retirement system, 37968
or under any successor retirement program enacted by the congress 37969
of the United States that is established and maintained for 37970
retired employees of the United States government, and such 37971
retirement income is based, in whole or in part, on credit for 37972
the taxpayer's military service, the deduction allowed under this 37973
division shall include only that portion of such retirement 37974
income that is attributable to the taxpayer's military service, 37975
to the extent that portion of such retirement income is otherwise 37976
included in federal adjusted gross income and is not otherwise 37977
deducted under this section. Any amount deducted under division 37978
(A)(26) of this section is not included in a taxpayer's 37979
adjusted gross income for the purposes of section 5747.055 of 37980
the Revised Code. No amount may be deducted under division 37981
(A)(26) of this section on the basis of which a credit was 37982
claimed under section 5747.055 of the Revised Code.37983

       (27) Deduct, to the extent not otherwise deducted or excluded 37984
in computing federal or Ohio adjusted gross income for the taxable 37985
year, the amount the taxpayer received during the taxable year 37986
from the military injury relief fund created in section 5101.98 of 37987
the Revised Code.37988

       (B) "Business income" means income, including gain or loss,37989
arising from transactions, activities, and sources in the regular37990
course of a trade or business and includes income, gain, or loss37991
from real property, tangible property, and intangible property if37992
the acquisition, rental, management, and disposition of the37993
property constitute integral parts of the regular course of a37994
trade or business operation. "Business income" includes income,37995
including gain or loss, from a partial or complete liquidation of37996
a business, including, but not limited to, gain or loss from the37997
sale or other disposition of goodwill.37998

       (C) "Nonbusiness income" means all income other than business 37999
income and may include, but is not limited to, compensation, rents 38000
and royalties from real or tangible personal property, capital 38001
gains, interest, dividends and distributions, patent or copyright 38002
royalties, or lottery winnings, prizes, and awards.38003

       (D) "Compensation" means any form of remuneration paid to an38004
employee for personal services.38005

       (E) "Fiduciary" means a guardian, trustee, executor,38006
administrator, receiver, conservator, or any other person acting38007
in any fiduciary capacity for any individual, trust, or estate.38008

       (F) "Fiscal year" means an accounting period of twelve months 38009
ending on the last day of any month other than December.38010

       (G) "Individual" means any natural person.38011

       (H) "Internal Revenue Code" means the "Internal Revenue Code38012
of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as amended.38013

       (I) "Resident" means any of the following, provided that38014
division (I)(3) of this section applies only to taxable years of a38015
trust beginning in 2002 or thereafter:38016

       (1) An individual who is domiciled in this state, subject to38017
section 5747.24 of the Revised Code;38018

       (2) The estate of a decedent who at the time of death was38019
domiciled in this state. The domicile tests of section 5747.24 of38020
the Revised Code are not controlling for purposes of division 38021
(I)(2) of this section.38022

       (3) A trust that, in whole or part, resides in this state. If38023
only part of a trust resides in this state, the trust is a38024
resident only with respect to that part.38025

       For the purposes of division (I)(3) of this section:38026

       (a) A trust resides in this state for the trust's current38027
taxable year to the extent, as described in division (I)(3)(d) of38028
this section, that the trust consists directly or indirectly, in 38029
whole or in part, of assets, net of any related liabilities, that 38030
were transferred, or caused to be transferred, directly or 38031
indirectly, to the trust by any of the following:38032

        (i) A person, a court, or a governmental entity or 38033
instrumentality on account of the death of a decedent, but only if 38034
the trust is described in division (I)(3)(e)(i) or (ii) of this 38035
section;38036

       (ii) A person who was domiciled in this state for the 38037
purposes of this chapter when the person directly or indirectly 38038
transferred assets to an irrevocable trust, but only if at least 38039
one of the trust's qualifying beneficiaries is domiciled in this 38040
state for the purposes of this chapter during all or some portion 38041
of the trust's current taxable year;38042

       (iii) A person who was domiciled in this state for the38043
purposes of this chapter when the trust document or instrument or38044
part of the trust document or instrument became irrevocable, but38045
only if at least one of the trust's qualifying beneficiaries is a 38046
resident domiciled in this state for the purposes of this chapter38047
during all or some portion of the trust's current taxable year. If 38048
a trust document or instrument became irrevocable upon the death 38049
of a person who at the time of death was domiciled in this state 38050
for purposes of this chapter, that person is a person described in 38051
division (I)(3)(a)(iii) of this section.38052

        (b) A trust is irrevocable to the extent that the transferor 38053
is not considered to be the owner of the net assets of the trust 38054
under sections 671 to 678 of the Internal Revenue Code.38055

       (c) With respect to a trust other than a charitable lead38056
trust, "qualifying beneficiary" has the same meaning as "potential38057
current beneficiary" as defined in section 1361(e)(2) of the38058
Internal Revenue Code, and with respect to a charitable lead trust38059
"qualifying beneficiary" is any current, future, or contingent38060
beneficiary, but with respect to any trust "qualifying38061
beneficiary" excludes a person or a governmental entity or38062
instrumentality to any of which a contribution would qualify for38063
the charitable deduction under section 170 of the Internal Revenue38064
Code.38065

        (d) For the purposes of division (I)(3)(a) of this section,38066
the extent to which a trust consists directly or indirectly, in38067
whole or in part, of assets, net of any related liabilities, that38068
were transferred directly or indirectly, in whole or part, to the38069
trust by any of the sources enumerated in that division shall be38070
ascertained by multiplying the fair market value of the trust's38071
assets, net of related liabilities, by the qualifying ratio, which38072
shall be computed as follows:38073

        (i) The first time the trust receives assets, the numerator38074
of the qualifying ratio is the fair market value of those assets38075
at that time, net of any related liabilities, from sources38076
enumerated in division (I)(3)(a) of this section. The denominator38077
of the qualifying ratio is the fair market value of all the38078
trust's assets at that time, net of any related liabilities.38079

        (ii) Each subsequent time the trust receives assets, a38080
revised qualifying ratio shall be computed. The numerator of the38081
revised qualifying ratio is the sum of (1) the fair market value38082
of the trust's assets immediately prior to the subsequent38083
transfer, net of any related liabilities, multiplied by the38084
qualifying ratio last computed without regard to the subsequent38085
transfer, and (2) the fair market value of the subsequently38086
transferred assets at the time transferred, net of any related38087
liabilities, from sources enumerated in division (I)(3)(a) of this38088
section. The denominator of the revised qualifying ratio is the38089
fair market value of all the trust's assets immediately after the38090
subsequent transfer, net of any related liabilities.38091

       (iii) Whether a transfer to the trust is by or from any of 38092
the sources enumerated in division (I)(3)(a) of this section shall 38093
be ascertained without regard to the domicile of the trust's 38094
beneficiaries.38095

        (e) For the purposes of division (I)(3)(a)(i) of this38096
section:38097

        (i) A trust is described in division (I)(3)(e)(i) of this38098
section if the trust is a testamentary trust and the testator of38099
that testamentary trust was domiciled in this state at the time of38100
the testator's death for purposes of the taxes levied under38101
Chapter 5731. of the Revised Code.38102

        (ii) A trust is described in division (I)(3)(e)(ii) of this38103
section if the transfer is a qualifying transfer described in any38104
of divisions (I)(3)(f)(i) to (vi) of this section, the trust is an38105
irrevocable inter vivos trust, and at least one of the trust's38106
qualifying beneficiaries is domiciled in this state for purposes38107
of this chapter during all or some portion of the trust's current38108
taxable year.38109

        (f) For the purposes of division (I)(3)(e)(ii) of this38110
section, a "qualifying transfer" is a transfer of assets, net of38111
any related liabilities, directly or indirectly to a trust, if the38112
transfer is described in any of the following:38113

        (i) The transfer is made to a trust, created by the decedent 38114
before the decedent's death and while the decedent was domiciled 38115
in this state for the purposes of this chapter, and, prior to the 38116
death of the decedent, the trust became irrevocable while the 38117
decedent was domiciled in this state for the purposes of this 38118
chapter.38119

        (ii) The transfer is made to a trust to which the decedent,38120
prior to the decedent's death, had directly or indirectly38121
transferred assets, net of any related liabilities, while the38122
decedent was domiciled in this state for the purposes of this38123
chapter, and prior to the death of the decedent the trust became38124
irrevocable while the decedent was domiciled in this state for the38125
purposes of this chapter.38126

        (iii) The transfer is made on account of a contractual38127
relationship existing directly or indirectly between the38128
transferor and either the decedent or the estate of the decedent38129
at any time prior to the date of the decedent's death, and the38130
decedent was domiciled in this state at the time of death for38131
purposes of the taxes levied under Chapter 5731. of the Revised38132
Code.38133

        (iv) The transfer is made to a trust on account of a38134
contractual relationship existing directly or indirectly between38135
the transferor and another person who at the time of the38136
decedent's death was domiciled in this state for purposes of this38137
chapter.38138

        (v) The transfer is made to a trust on account of the will of 38139
a testator.38140

        (vi) The transfer is made to a trust created by or caused to 38141
be created by a court, and the trust was directly or indirectly38142
created in connection with or as a result of the death of an38143
individual who, for purposes of the taxes levied under Chapter38144
5731. of the Revised Code, was domiciled in this state at the time38145
of the individual's death.38146

       (g) The tax commissioner may adopt rules to ascertain the38147
part of a trust residing in this state.38148

       (J) "Nonresident" means an individual or estate that is not a 38149
resident. An individual who is a resident for only part of a38150
taxable year is a nonresident for the remainder of that taxable38151
year.38152

       (K) "Pass-through entity" has the same meaning as in section38153
5733.04 of the Revised Code.38154

       (L) "Return" means the notifications and reports required to38155
be filed pursuant to this chapter for the purpose of reporting the38156
tax due and includes declarations of estimated tax when so38157
required.38158

       (M) "Taxable year" means the calendar year or the taxpayer's38159
fiscal year ending during the calendar year, or fractional part38160
thereof, upon which the adjusted gross income is calculated38161
pursuant to this chapter.38162

       (N) "Taxpayer" means any person subject to the tax imposed by 38163
section 5747.02 of the Revised Code or any pass-through entity38164
that makes the election under division (D) of section 5747.08 of38165
the Revised Code.38166

       (O) "Dependents" means dependents as defined in the Internal38167
Revenue Code and as claimed in the taxpayer's federal income tax38168
return for the taxable year or which the taxpayer would have been38169
permitted to claim had the taxpayer filed a federal income tax38170
return.38171

       (P) "Principal county of employment" means, in the case of a38172
nonresident, the county within the state in which a taxpayer38173
performs services for an employer or, if those services are38174
performed in more than one county, the county in which the major38175
portion of the services are performed.38176

       (Q) As used in sections 5747.50 to 5747.55 of the Revised38177
Code:38178

       (1) "Subdivision" means any county, municipal corporation,38179
park district, or township.38180

       (2) "Essential local government purposes" includes all38181
functions that any subdivision is required by general law to38182
exercise, including like functions that are exercised under a38183
charter adopted pursuant to the Ohio Constitution.38184

       (R) "Overpayment" means any amount already paid that exceeds38185
the figure determined to be the correct amount of the tax.38186

       (S) "Taxable income" or "Ohio taxable income" applies only to 38187
estates and trusts, and means federal taxable income, as defined 38188
and used in the Internal Revenue Code, adjusted as follows:38189

       (1) Add interest or dividends, net of ordinary, necessary,38190
and reasonable expenses not deducted in computing federal taxable38191
income, on obligations or securities of any state or of any38192
political subdivision or authority of any state, other than this38193
state and its subdivisions and authorities, but only to the extent 38194
that such net amount is not otherwise includible in Ohio taxable 38195
income and is described in either division (S)(1)(a) or (b) of 38196
this section:38197

        (a) The net amount is not attributable to the S portion of an 38198
electing small business trust and has not been distributed to38199
beneficiaries for the taxable year;38200

        (b) The net amount is attributable to the S portion of an38201
electing small business trust for the taxable year.38202

       (2) Add interest or dividends, net of ordinary, necessary,38203
and reasonable expenses not deducted in computing federal taxable38204
income, on obligations of any authority, commission,38205
instrumentality, territory, or possession of the United States to38206
the extent that the interest or dividends are exempt from federal38207
income taxes but not from state income taxes, but only to the38208
extent that such net amount is not otherwise includible in Ohio38209
taxable income and is described in either division (S)(1)(a) or38210
(b) of this section;38211

       (3) Add the amount of personal exemption allowed to the38212
estate pursuant to section 642(b) of the Internal Revenue Code;38213

       (4) Deduct interest or dividends, net of related expenses38214
deducted in computing federal taxable income, on obligations of38215
the United States and its territories and possessions or of any38216
authority, commission, or instrumentality of the United States to38217
the extent that the interest or dividends are exempt from state38218
taxes under the laws of the United States, but only to the extent38219
that such amount is included in federal taxable income and is38220
described in either division (S)(1)(a) or (b) of this section;38221

       (5) Deduct the amount of wages and salaries, if any, not38222
otherwise allowable as a deduction but that would have been38223
allowable as a deduction in computing federal taxable income for38224
the taxable year, had the targeted jobs credit allowed under38225
sections 38, 51, and 52 of the Internal Revenue Code not been in38226
effect, but only to the extent such amount relates either to38227
income included in federal taxable income for the taxable year or38228
to income of the S portion of an electing small business trust for38229
the taxable year;38230

       (6) Deduct any interest or interest equivalent, net of38231
related expenses deducted in computing federal taxable income, on38232
public obligations and purchase obligations, but only to the38233
extent that such net amount relates either to income included in38234
federal taxable income for the taxable year or to income of the S38235
portion of an electing small business trust for the taxable year;38236

       (7) Add any loss or deduct any gain resulting from sale,38237
exchange, or other disposition of public obligations to the extent38238
that such loss has been deducted or such gain has been included in38239
computing either federal taxable income or income of the S portion38240
of an electing small business trust for the taxable year;38241

       (8) Except in the case of the final return of an estate, add38242
any amount deducted by the taxpayer on both its Ohio estate tax38243
return pursuant to section 5731.14 of the Revised Code, and on its38244
federal income tax return in determining federal taxable income;38245

       (9)(a) Deduct any amount included in federal taxable income38246
solely because the amount represents a reimbursement or refund of38247
expenses that in a previous year the decedent had deducted as an38248
itemized deduction pursuant to section 63 of the Internal Revenue38249
Code and applicable treasury regulations. The deduction otherwise38250
allowed under division (S)(9)(a) of this section shall be reduced38251
to the extent the reimbursement is attributable to an amount the38252
taxpayer or decedent deducted under this section in any taxable38253
year.38254

       (b) Add any amount not otherwise included in Ohio taxable38255
income for any taxable year to the extent that the amount is38256
attributable to the recovery during the taxable year of any amount38257
deducted or excluded in computing federal or Ohio taxable income38258
in any taxable year, but only to the extent such amount has not38259
been distributed to beneficiaries for the taxable year.38260

       (10) Deduct any portion of the deduction described in section 38261
1341(a)(2) of the Internal Revenue Code, for repaying previously 38262
reported income received under a claim of right, that meets both 38263
of the following requirements:38264

       (a) It is allowable for repayment of an item that was38265
included in the taxpayer's taxable income or the decedent's38266
adjusted gross income for a prior taxable year and did not qualify38267
for a credit under division (A) or (B) of section 5747.05 of the38268
Revised Code for that year.38269

       (b) It does not otherwise reduce the taxpayer's taxable38270
income or the decedent's adjusted gross income for the current or38271
any other taxable year.38272

       (11) Add any amount claimed as a credit under section38273
5747.059 of the Revised Code to the extent that the amount38274
satisfies either of the following:38275

       (a) The amount was deducted or excluded from the computation38276
of the taxpayer's federal taxable income as required to be38277
reported for the taxpayer's taxable year under the Internal38278
Revenue Code;38279

       (b) The amount resulted in a reduction in the taxpayer's38280
federal taxable income as required to be reported for any of the38281
taxpayer's taxable years under the Internal Revenue Code.38282

       (12) Deduct any amount, net of related expenses deducted in38283
computing federal taxable income, that a trust is required to38284
report as farm income on its federal income tax return, but only38285
if the assets of the trust include at least ten acres of land38286
satisfying the definition of "land devoted exclusively to38287
agricultural use" under section 5713.30 of the Revised Code,38288
regardless of whether the land is valued for tax purposes as such38289
land under sections 5713.30 to 5713.38 of the Revised Code. If the38290
trust is a pass-through entity investor, section 5747.231 of the38291
Revised Code applies in ascertaining if the trust is eligible to38292
claim the deduction provided by division (S)(12) of this section38293
in connection with the pass-through entity's farm income.38294

        Except for farm income attributable to the S portion of an38295
electing small business trust, the deduction provided by division38296
(S)(12) of this section is allowed only to the extent that the38297
trust has not distributed such farm income. Division (S)(12) of38298
this section applies only to taxable years of a trust beginning in38299
2002 or thereafter.38300

       (13) Add the net amount of income described in section 641(c)38301
of the Internal Revenue Code to the extent that amount is not38302
included in federal taxable income.38303

       (14) Add or deduct the amount the taxpayer would be required38304
to add or deduct under division (A)(20) or (21) of this section if38305
the taxpayer's Ohio taxable income were computed in the same38306
manner as an individual's Ohio adjusted gross income is computed38307
under this section. In the case of a trust, division (S)(14) of38308
this section applies only to any of the trust's taxable years38309
beginning in 2002 or thereafter.38310

       (T) "School district income" and "school district income tax" 38311
have the same meanings as in section 5748.01 of the Revised Code.38312

       (U) As used in divisions (A)(8), (A)(9), (S)(6), and (S)(7)38313
of this section, "public obligations," "purchase obligations," and38314
"interest or interest equivalent" have the same meanings as in38315
section 5709.76 of the Revised Code.38316

       (V) "Limited liability company" means any limited liability38317
company formed under Chapter 1705. of the Revised Code or under38318
the laws of any other state.38319

       (W) "Pass-through entity investor" means any person who,38320
during any portion of a taxable year of a pass-through entity, is38321
a partner, member, shareholder, or equity investor in that38322
pass-through entity.38323

       (X) "Banking day" has the same meaning as in section 1304.0138324
of the Revised Code.38325

       (Y) "Month" means a calendar month.38326

       (Z) "Quarter" means the first three months, the second three38327
months, the third three months, or the last three months of the38328
taxpayer's taxable year.38329

       (AA)(1) "Eligible institution" means a state university or38330
state institution of higher education as defined in section38331
3345.011 of the Revised Code, or a private, nonprofit college,38332
university, or other post-secondary institution located in this38333
state that possesses a certificate of authorization issued by the38334
Ohio board of regents pursuant to Chapter 1713. of the Revised38335
Code or a certificate of registration issued by the state board of38336
career colleges and schools under Chapter 3332. of the Revised38337
Code.38338

       (2) "Qualified tuition and fees" means tuition and fees38339
imposed by an eligible institution as a condition of enrollment or38340
attendance, not exceeding two thousand five hundred dollars in38341
each of the individual's first two years of post-secondary38342
education. If the individual is a part-time student, "qualified38343
tuition and fees" includes tuition and fees paid for the academic38344
equivalent of the first two years of post-secondary education38345
during a maximum of five taxable years, not exceeding a total of38346
five thousand dollars. "Qualified tuition and fees" does not38347
include:38348

       (a) Expenses for any course or activity involving sports,38349
games, or hobbies unless the course or activity is part of the38350
individual's degree or diploma program;38351

       (b) The cost of books, room and board, student activity fees,38352
athletic fees, insurance expenses, or other expenses unrelated to 38353
the individual's academic course of instruction;38354

       (c) Tuition, fees, or other expenses paid or reimbursed38355
through an employer, scholarship, grant in aid, or other38356
educational benefit program.38357

       (BB)(1) "Modified business income" means the business income38358
included in a trust's Ohio taxable income after such taxable38359
income is first reduced by the qualifying trust amount, if any.38360

       (2) "Qualifying trust amount" of a trust means capital gains38361
and losses from the sale, exchange, or other disposition of equity38362
or ownership interests in, or debt obligations of, a qualifying38363
investee to the extent included in the trust's Ohio taxable 38364
income, but only if the following requirements are satisfied:38365

        (a) The book value of the qualifying investee's physical 38366
assets in this state and everywhere, as of the last day of the 38367
qualifying investee's fiscal or calendar year ending immediately 38368
prior to the date on which the trust recognizes the gain or loss, 38369
is available to the trust.38370

       (b) The requirements of section 5747.011 of the Revised Code38371
are satisfied for the trust's taxable year in which the trust38372
recognizes the gain or loss.38373

        Any gain or loss that is not a qualifying trust amount is38374
modified business income, qualifying investment income, or38375
modified nonbusiness income, as the case may be.38376

       (3) "Modified nonbusiness income" means a trust's Ohio38377
taxable income other than modified business income, other than the38378
qualifying trust amount, and other than qualifying investment38379
income, as defined in section 5747.012 of the Revised Code, to the38380
extent such qualifying investment income is not otherwise part of38381
modified business income.38382

       (4) "Modified Ohio taxable income" applies only to trusts,38383
and means the sum of the amounts described in divisions (BB)(4)(a) 38384
to (c) of this section:38385

       (a) The fraction, calculated under section 5747.013, and 38386
applying section 5747.231 of the Revised Code, multiplied by the 38387
sum of the following amounts:38388

        (i) The trust's modified business income;38389

        (ii) The trust's qualifying investment income, as defined in 38390
section 5747.012 of the Revised Code, but only to the extent the 38391
qualifying investment income does not otherwise constitute38392
modified business income and does not otherwise constitute a38393
qualifying trust amount.38394

       (b) The qualifying trust amount multiplied by a fraction, the 38395
numerator of which is the sum of the book value of the qualifying 38396
investee's physical assets in this state on the last day of the 38397
qualifying investee's fiscal or calendar year ending immediately 38398
prior to the day on which the trust recognizes the qualifying 38399
trust amount, and the denominator of which is the sum of the book 38400
value of the qualifying investee's total physical assets 38401
everywhere on the last day of the qualifying investee's fiscal or 38402
calendar year ending immediately prior to the day on which the 38403
trust recognizes the qualifying trust amount. If, for a taxable 38404
year, the trust recognizes a qualifying trust amount with respect 38405
to more than one qualifying investee, the amount described in 38406
division (BB)(4)(b) of this section shall equal the sum of the38407
products so computed for each such qualifying investee.38408

       (c)(i) With respect to a trust or portion of a trust that is 38409
a resident as ascertained in accordance with division (I)(3)(d) of 38410
this section, its modified nonbusiness income.38411

        (ii) With respect to a trust or portion of a trust that is38412
not a resident as ascertained in accordance with division38413
(I)(3)(d) of this section, the amount of its modified nonbusiness38414
income satisfying the descriptions in divisions (B)(2) to (5) of38415
section 5747.20 of the Revised Code, except as otherwise provided 38416
in division (BB)(4)(c)(ii) of this section. With respect to a 38417
trust or portion of a trust that is not a resident as ascertained 38418
in accordance with division (I)(3)(d) of this section, the trust's 38419
portion of modified nonbusiness income recognized from the sale, 38420
exchange, or other disposition of a debt interest in or equity 38421
interest in a section 5747.212 entity, as defined in section 38422
5747.212 of the Revised Code, without regard to division (A) of 38423
that section, shall not be allocated to this state in accordance 38424
with section 5747.20 of the Revised Code but shall be apportioned 38425
to this state in accordance with division (B) of section 5747.212 38426
of the Revised Code without regard to division (A) of that 38427
section.38428

       If the allocation and apportionment of a trust's income under38429
divisions (BB)(4)(a) and (c) of this section do not fairly38430
represent the modified Ohio taxable income of the trust in this38431
state, the alternative methods described in division (C) of38432
section 5747.21 of the Revised Code may be applied in the manner38433
and to the same extent provided in that section.38434

       (5)(a) Except as set forth in division (BB)(5)(b) of this 38435
section, "qualifying investee" means a person in which a trust has 38436
an equity or ownership interest, or a person or unit of government 38437
the debt obligations of either of which are owned by a trust. For 38438
the purposes of division (BB)(2)(a) of this section and for the 38439
purpose of computing the fraction described in division (BB)(4)(b) 38440
of this section, all of the following apply:38441

        (i) If the qualifying investee is a member of a qualifying38442
controlled group on the last day of the qualifying investee's38443
fiscal or calendar year ending immediately prior to the date on38444
which the trust recognizes the gain or loss, then "qualifying38445
investee" includes all persons in the qualifying controlled group38446
on such last day.38447

        (ii) If the qualifying investee, or if the qualifying38448
investee and any members of the qualifying controlled group of38449
which the qualifying investee is a member on the last day of the38450
qualifying investee's fiscal or calendar year ending immediately38451
prior to the date on which the trust recognizes the gain or loss,38452
separately or cumulatively own, directly or indirectly, on the38453
last day of the qualifying investee's fiscal or calendar year38454
ending immediately prior to the date on which the trust recognizes38455
the qualifying trust amount, more than fifty per cent of the38456
equity of a pass-through entity, then the qualifying investee and38457
the other members are deemed to own the proportionate share of the38458
pass-through entity's physical assets which the pass-through38459
entity directly or indirectly owns on the last day of the38460
pass-through entity's calendar or fiscal year ending within or38461
with the last day of the qualifying investee's fiscal or calendar38462
year ending immediately prior to the date on which the trust38463
recognizes the qualifying trust amount.38464

        (iii) For the purposes of division (BB)(5)(a)(iii) of this38465
section, "upper level pass-through entity" means a pass-through38466
entity directly or indirectly owning any equity of another38467
pass-through entity, and "lower level pass-through entity" means38468
that other pass-through entity.38469

        An upper level pass-through entity, whether or not it is also 38470
a qualifying investee, is deemed to own, on the last day of the 38471
upper level pass-through entity's calendar or fiscal year, the38472
proportionate share of the lower level pass-through entity's38473
physical assets that the lower level pass-through entity directly38474
or indirectly owns on the last day of the lower level pass-through38475
entity's calendar or fiscal year ending within or with the last38476
day of the upper level pass-through entity's fiscal or calendar38477
year. If the upper level pass-through entity directly and38478
indirectly owns less than fifty per cent of the equity of the38479
lower level pass-through entity on each day of the upper level38480
pass-through entity's calendar or fiscal year in which or with38481
which ends the calendar or fiscal year of the lower level38482
pass-through entity and if, based upon clear and convincing38483
evidence, complete information about the location and cost of the38484
physical assets of the lower pass-through entity is not available38485
to the upper level pass-through entity, then solely for purposes38486
of ascertaining if a gain or loss constitutes a qualifying trust38487
amount, the upper level pass-through entity shall be deemed as38488
owning no equity of the lower level pass-through entity for each38489
day during the upper level pass-through entity's calendar or38490
fiscal year in which or with which ends the lower level38491
pass-through entity's calendar or fiscal year. Nothing in division 38492
(BB)(5)(a)(iii) of this section shall be construed to provide for 38493
any deduction or exclusion in computing any trust's Ohio taxable 38494
income.38495

       (b) With respect to a trust that is not a resident for the38496
taxable year and with respect to a part of a trust that is not a38497
resident for the taxable year, "qualifying investee" for that38498
taxable year does not include a C corporation if both of the38499
following apply:38500

       (i) During the taxable year the trust or part of the trust38501
recognizes a gain or loss from the sale, exchange, or other38502
disposition of equity or ownership interests in, or debt38503
obligations of, the C corporation.38504

       (ii) Such gain or loss constitutes nonbusiness income.38505

        (6) "Available" means information is such that a person is 38506
able to learn of the information by the due date plus extensions, 38507
if any, for filing the return for the taxable year in which the 38508
trust recognizes the gain or loss.38509

        (CC) "Qualifying controlled group" has the same meaning as in 38510
section 5733.04 of the Revised Code.38511

        (DD) "Related member" has the same meaning as in section38512
5733.042 of the Revised Code.38513

       (EE)(1) For the purposes of division (EE) of this section: 38514

       (a) "Qualifying person" means any person other than a 38515
qualifying corporation.38516

       (b) "Qualifying corporation" means any person classified for 38517
federal income tax purposes as an association taxable as a 38518
corporation, except either of the following:38519

       (i) A corporation that has made an election under subchapter 38520
S, chapter one, subtitle A, of the Internal Revenue Code for its 38521
taxable year ending within, or on the last day of, the investor's 38522
taxable year;38523

       (ii) A subsidiary that is wholly owned by any corporation 38524
that has made an election under subchapter S, chapter one, 38525
subtitle A of the Internal Revenue Code for its taxable year 38526
ending within, or on the last day of, the investor's taxable year.38527

       (2) For the purposes of this chapter, unless expressly stated 38528
otherwise, no qualifying person indirectly owns any asset directly 38529
or indirectly owned by any qualifying corporation.38530

       (FF) For purposes of this chapter and Chapter 5751. of the 38531
Revised Code:38532

       (1) "Trust" does not include a qualified pre-income tax 38533
trust.38534

       (2) A "qualified pre-income tax trust" is any pre-income tax 38535
trust that makes a qualifying pre-income tax trust election as 38536
described in division (FF)(3) of this section.38537

       (3) A "qualifying pre-income tax trust election" is an 38538
election by a pre-income tax trust to subject to the tax imposed 38539
by section 5751.02 of the Revised Code the pre-income tax trust 38540
and all pass-through entities of which the trust owns or 38541
controls, directly, indirectly, or constructively through related 38542
interests, five per cent or more of the ownership or equity 38543
interests. The trustee shall notify the tax commissioner in 38544
writing of the election on or before April 15, 2006. The 38545
election, if timely made, shall be effective on and after January 38546
1, 2006, and shall apply for all tax periods and tax years until 38547
revoked by the trustee of the trust.38548

       (4) A "pre-income tax trust" is a trust that satisfies all of 38549
the following requirements:38550

       (a) The document or instrument creating the trust was 38551
executed by the grantor before January 1, 1972;38552

       (b) The trust became irrevocable upon the creation of the 38553
trust; and38554

       (c) The grantor was domiciled in this state at the time the 38555
trust was created.38556

       Sec. 5747.122.  (A) The tax commissioner, in accordance with38557
section 5101.184 of the Revised Code, shall cooperate with the38558
director of job and family services to collect overpayments of38559
assistance under Chapter 5107., 5111., or 5115., former Chapter38560
5113., or section 5101.54 of the Revised Code from refunds of38561
state income taxes for taxable year 1992 and thereafter that are38562
payable to the recipients of such overpayments. The tax 38563
commissioner, in accordance with section 5160.45 of the Revised 38564
Code, shall cooperate with the director of health care 38565
administration to collect overpayments of assistance under the 38566
disability medical assistance program or medicaid program from 38567
refunds of state income taxes for taxable year 1992 and thereafter 38568
that are payable to disability medical assistance recipients or 38569
medicaid recipients.38570

       (B) At the request of the department of job and family38571
services or department of health care administration in connection 38572
with the collection of an overpayment of assistance from a refund 38573
of state income taxes pursuant to this section and section 38574
5101.184 or 5160.45 of the Revised Code, the tax commissioner 38575
shall release to the department the home address and social 38576
security number of any recipient of assistance whose overpayment 38577
may be collected from a refund of state income taxes under those38578
sections.38579

       (C) In the case of a joint income tax return for two people38580
who were not married to each other at the time one of them38581
received an overpayment of assistance, only the portion of a38582
refund that is due to the recipient of the overpayment shall be38583
available for collection of the overpayment under this section and38584
section 5101.184 or 5160.45 of the Revised Code. The tax 38585
commissioner shall determine such portion. A recipient's spouse 38586
who objects to the portion as determined by the commissioner may 38587
file a complaint with the commissioner within twenty-one days 38588
after receiving notice of the collection, and the commissioner 38589
shall afford the spouse an opportunity to be heard on the 38590
complaint. The commissioner shall waive or extend the 38591
twenty-one-day period if the recipient's spouse establishes that 38592
such action is necessary to avoid unjust, unfair, or unreasonable 38593
results. After the hearing, the commissioner shall make a final38594
determination of the portion of the refund available for38595
collection of the overpayment.38596

       (D) The welfare overpayment intercept fund is hereby created38597
in the state treasury. The tax commissioner shall deposit amounts38598
collected from income tax refunds under this section to the credit38599
of the welfare overpayment intercept fund. The director of job and38600
family services and director of health care administration shall 38601
distribute money in the fund in accordance with appropriate 38602
federal or state laws and procedures regarding collection of 38603
welfare overpayments and disability medical assistance program and 38604
medicaid payments.38605

       Sec. 5747.18.  The tax commissioner shall enforce and38606
administer this chapter. In addition to any other powers conferred 38607
upon the commissioner by law, the commissioner may:38608

       (A) Prescribe all forms required to be filed pursuant to this 38609
chapter;38610

       (B) Adopt such rules as the commissioner finds necessary to 38611
carry out this chapter;38612

       (C) Appoint and employ such personnel as are necessary to38613
carry out the duties imposed upon the commissioner by this 38614
chapter.38615

       Any information gained as the result of returns,38616
investigations, hearings, or verifications required or authorized38617
by this chapter is confidential, and no person shall disclose such 38618
information, except for official purposes, or as provided by38619
section 3125.43, 4123.271, 4123.591, 4507.023, or 5101.182, or 38620
5160.44, division (B) of section 5703.21 of the Revised Code, or 38621
in accordance with a proper judicial order. The tax commissioner 38622
may furnish the internal revenue service with copies of returns or 38623
reports filed and may furnish the officer of a municipal 38624
corporation charged with the duty of enforcing a tax subject to 38625
Chapter 718. of the Revised Code with the names, addresses, and 38626
identification numbers of taxpayers who may be subject to such 38627
tax. A municipal corporation shall use this information for tax 38628
collection purposes only. This section does not prohibit the 38629
publication of statistics in a form which does not disclose 38630
information with respect to individual taxpayers.38631

       Sec. 5751.081.  As used in this section, "debt to this state" 38632
means unpaid taxes due the state, unpaid workers' compensation 38633
premiums due under section 4123.35 of the Revised Code, unpaid 38634
unemployment compensation contributions due under section 4141.25 38635
of the Revised Code, unpaid unemployment compensation payment in 38636
lieu of contribution under section 4141.241 of the Revised Code, 38637
unpaid fee payable to the state or to the clerk of courts pursuant 38638
to section 4505.06 of the Revised Code, incorrect medical 38639
assistancemedicaid payments under section 5111.02 of the Revised 38640
Code, or any unpaid charge, penalty, or interest arising from any 38641
of the foregoing.38642

       If a taxpayer entitled to a refund under section 5751.08 of 38643
the Revised Code owes any debt to this state, the amount 38644
refundable may be applied in satisfaction of the debt. If the 38645
amount refundable is less than the amount of the debt, it may be 38646
applied in partial satisfaction of the debt. If the amount 38647
refundable is greater than the amount of the debt, the amount 38648
remaining after satisfaction of the debt shall be refunded. This 38649
section applies only to debts that have become final. For the 38650
purposes of this section, a debt becomes final when, under the 38651
applicable law, any time provided for petition for reassessment, 38652
request for reconsideration, or other appeal of the legality or 38653
validity of the amount giving rise to the debt expires without an 38654
appeal having been filed in the manner provided by law.38655

       Sec. 5815.28.  (A) As used in this section:38656

       (1) "Ascertainable standard" includes a standard in a trust38657
instrument requiring the trustee to provide for the care, comfort,38658
maintenance, welfare, education, or general well-being of the38659
beneficiary.38660

       (2) "Disability" means any substantial, medically38661
determinable impairment that can be expected to result in death or38662
that has lasted or can be expected to last for a continuous period38663
of at least twelve months, except that "disability" does not38664
include an impairment that is the result of abuse of alcohol or38665
drugs.38666

       (3) "Political subdivision" and "state" have the same38667
meanings as in section 2744.01 of the Revised Code.38668

       (4) "Supplemental services" means services specified by rule38669
of the department of mental health under section 5119.01 of the38670
Revised Code or the department of mental retardation and38671
developmental disabilities under section 5123.04 of the Revised38672
Code that are provided to an individual with a disability in38673
addition to services the individual is eligible to receive under38674
programs authorized by federal or state law.38675

       (B) Any person may create a trust under this section to38676
provide funding for supplemental services for the benefit of38677
another individual who meets either of the following conditions:38678

       (1) The individual has a physical or mental disability and is 38679
eligible to receive services through the department of mental38680
retardation and developmental disabilities or a county board of38681
mental retardation and developmental disabilities;38682

       (2) The individual has a mental disability and is eligible to 38683
receive services through the department of mental health or a38684
board of alcohol, drug addiction, and mental health services.38685

       The trust may confer discretion upon the trustee and may38686
contain specific instructions or conditions governing the exercise38687
of the discretion.38688

       (C) The general division of the court of common pleas and the 38689
probate court of the county in which the beneficiary of a trust 38690
authorized by division (B) of this section resides or is confined 38691
have concurrent original jurisdiction to hear and determine 38692
actions pertaining to the trust. In any action pertaining to the 38693
trust in a court of common pleas or probate court and in any 38694
appeal of the action, all of the following apply to the trial or 38695
appellate court:38696

       (1) The court shall render determinations consistent with the 38697
testator's or other settlor's intent in creating the trust, as38698
evidenced by the terms of the trust instrument.38699

       (2) The court may order the trustee to exercise discretion38700
that the trust instrument confers upon the trustee only if the38701
instrument contains specific instructions or conditions governing38702
the exercise of that discretion and the trustee has failed to38703
comply with the instructions or conditions. In issuing an order38704
pursuant to this division, the court shall require the trustee to38705
exercise the trustee's discretion only in accordance with the38706
instructions or conditions.38707

       (3) The court may order the trustee to maintain the trust and 38708
distribute assets in accordance with rules adopted by the director 38709
of mental health under section 5119.01 of the Revised Code or the 38710
director of mental retardation and developmental disabilities 38711
under section 5123.04 of the Revised Code if the trustee has 38712
failed to comply with such rules.38713

       (D) To the extent permitted by federal law and subject to the 38714
provisions of division (C)(2) of this section pertaining to the 38715
enforcement of specific instructions or conditions governing a38716
trustee's discretion, a trust authorized by division (B) of this38717
section that confers discretion upon the trustee shall not be38718
considered an asset or resource of the beneficiary, the38719
beneficiary's estate, the settlor, or the settlor's estate and38720
shall be exempt from the claims of creditors, political38721
subdivisions, the state, other governmental entities, and other38722
claimants against the beneficiary, the beneficiary's estate, the38723
settlor, or the settlor's estate, including claims based on38724
provisions of Chapters 5111.,Chapter 5121., or 5123. of the38725
Revised Code or the medicaid program and claims sought to be 38726
satisfied by way of a civil action, subrogation, execution, 38727
garnishment, attachment, judicial sale, or other legal process, 38728
if all of the following apply:38729

       (1) At the time the trust is created, the trust principal38730
does not exceed the maximum amount determined under division (E)38731
of this section;38732

       (2) The trust instrument contains a statement of the 38733
settlor's intent, or otherwise clearly evidences the settlor's38734
intent, that the beneficiary does not have authority to compel the38735
trustee under any circumstances to furnish the beneficiary with38736
minimal or other maintenance or support, to make payments from the38737
principal of the trust or from the income derived from the38738
principal, or to convert any portion of the principal into cash,38739
whether pursuant to an ascertainable standard specified in the38740
instrument or otherwise;38741

       (3) The trust instrument provides that trust assets can be38742
used only to provide supplemental services, as defined by rule of38743
the director of mental health under section 5119.01 of the Revised38744
Code or the director of mental retardation and developmental38745
disabilities under section 5123.04 of the Revised Code, to the38746
beneficiary;38747

       (4) The trust is maintained and assets are distributed in38748
accordance with rules adopted by the director of mental health38749
under section 5119.01 of the Revised Code or the director of38750
mental retardation and developmental disabilities under section38751
5123.04 of the Revised Code;38752

       (5) The trust instrument provides that on the death of the38753
beneficiary, a portion of the remaining assets of the trust, which38754
shall be not less than fifty per cent of such assets, will be38755
deposited to the credit of the services fund for individuals with38756
mental illness created by section 5119.17 of the Revised Code or38757
the services fund for individuals with mental retardation and38758
developmental disabilities created by section 5123.40 of the38759
Revised Code.38760

       (E) In 1994, the trust principal maximum amount for a trust38761
created under this section shall be two hundred thousand dollars.38762
The maximum amount for a trust created under this section prior to 38763
November 11, 1994, may be increased to two hundred thousand38764
dollars.38765

       In 1995, the maximum amount for a trust created under this38766
section shall be two hundred two thousand dollars. Each year38767
thereafter, the maximum amount shall be the prior year's amount38768
plus two thousand dollars.38769

       (F) This section does not limit or otherwise affect the38770
creation, validity, interpretation, or effect of any trust that is38771
not created under this section.38772

       (G) Once a trustee takes action on a trust created by a38773
settlor under this section and disburses trust funds on behalf of38774
the beneficiary of the trust, then the trust may not be terminated38775
or otherwise revoked by a particular event or otherwise without38776
payment into the services fund created pursuant to section 5119.1738777
or 5123.40 of the Revised Code of an amount that is equal to the38778
disbursements made on behalf of the beneficiary for medical care38779
by the state from the date the trust vests but that is not more38780
than fifty per cent of the trust corpus.38781

       Sec. 5907.04.  Subject to the following paragraph, all 38782
members of the armed forces, who served in the regular or 38783
volunteer forces of the United States or the Ohio national guard 38784
or members of the naval militia during the war with Spain, the 38785
Philippine insurrection, the China relief expedition, the Indian 38786
war, the Mexican expedition, World War I, World War II, or during 38787
the period beginning June 25, 1950 and ending July 19, 1953, known 38788
as the Korean conflict, or during the period beginning August 5, 38789
1964, and ending July 1, 1973, known as the Vietnam conflict, or 38790
any person who is awarded either the armed forces expeditionary 38791
medal established by presidential executive order 10977 dated 38792
December 4, 1961, or the Vietnam service medal established by 38793
presidential executive order 11231 dated July 8, 1965, who have 38794
been honorably discharged or separated under honorable conditions 38795
therefrom, or any discharged members of the Polish and 38796
Czechoslovakian armed forces who served in armed conflict with an 38797
enemy of the United States in World War I or World War II who have 38798
been citizens of the United States for at least ten years, 38799
provided that the above-mentioned persons have been citizens of 38800
this state for five consecutive years or more at the date of 38801
making application for admission, are disabled by disease, wounds, 38802
or otherwise, and are by reason of such disability incapable of 38803
earning their living, and all members of the Ohio national guard 38804
or naval militia who have lost an arm or leg, or their sight, or 38805
become permanently disabled from any cause, while in the line and 38806
discharge of duty, and are not able to support themselves, may be 38807
admitted to a veterans' home under such rules as the director of 38808
veterans services adopts.38809

       A person who served in the armed forces of the United States 38810
as defined in division (E)(7) of section 5903.11 of the Revised 38811
Code is eligible for admission to a veterans' home under the 38812
preceding paragraph only if the person has the characteristics 38813
defined in division (B)(1) of section 5901.01 of the Revised Code.38814

       The superintendent of the Ohio veterans' home agency shall38815
promptly and diligently pursue the establishment of the38816
eligibility for medical assistance under Chapter 5111. of the38817
Revised Codemedicaid program of all persons admitted to a 38818
veterans' home and all residents of a home who appear to qualify 38819
and shall promptly and diligently pursue and maintain the 38820
certification of each home's compliance with federal laws and 38821
regulations governing participation in the medical assistance38822
medicaid program to include as large as possible a part of the38823
home's bed capacity.38824

        Veterans' homes may reserve a bed during the temporary 38825
absence of a resident or patient from the home, including a 38826
nursing home within it, under conditions prescribed by the 38827
director, to include hospitalization for an acute condition,38828
visits with relatives and friends, and participation in38829
therapeutic programs outside the home. A home shall not reserve a 38830
bed for more than thirty days, except that absences for more than 38831
thirty days due to hospitalization may be authorized.38832

       Section 2. That existing sections 9.231, 9.239, 9.24, 101.39, 38833
101.391, 103.144, 109.572, 109.85, 117.10, 119.01, 121.02, 121.03, 38834
122.15, 124.30, 124.301, 127.16, 131.23, 145.27, 145.58, 149.431, 38835
169.02, 173.14, 173.20, 173.21, 173.26, 173.35, 173.351, 173.394, 38836
173.40, 173.401, 173.42, 173.45, 173.47, 173.50, 173.71, 173.72, 38837
173.721, 173.722, 173.723, 173.724, 173.73, 173.731, 173.732, 38838
173.74, 173.741, 173.742, 173.75, 173.751, 173.752, 173.753, 38839
173.76, 173.77, 173.771, 173.772, 173.773, 173.78, 173.79, 38840
173.791, 173.80, 173.801, 173.802, 173.803, 173.81, 173.811, 38841
173.812, 173.813, 173.814, 173.815, 173.82, 173.83, 173.831, 38842
173.832, 173.833, 173.84, 173.85, 173.86, 173.861, 173.87, 38843
173.871, 173.872, 173.873, 173.874, 173.875, 173.876, 173.88, 38844
173.89, 173.891, 173.892, 173.90, 173.91, 173.99, 317.08, 317.36, 38845
323.01, 329.04, 329.051, 329.06, 329.14, 340.03, 340.091, 340.16, 38846
341.192, 505.84, 742.41, 955.201, 1337.11, 1347.08, 1731.04, 38847
1739.061, 1751.01, 1751.11, 1751.12, 1751.18, 1751.271, 1751.31, 38848
1751.60, 1751.88, 1751.89, 1923.14, 2113.041, 2113.06, 2117.061, 38849
2117.25, 2133.01, 2151.3514, 2305.234, 2307.65, 2317.02, 2335.39, 38850
2505.02, 2705.02, 2744.05, 2903.33, 2913.40, 2913.401, 2921.01, 38851
2921.13, 2945.401, 3101.051, 3107.083, 3111.04, 3111.72, 3113.06,38852
3119.29. 3119.54, 3121.441, 3121.898, 3125.36, 3307.20, 3309.22, 38853
3313.714, 3313.715, 3323.021, 3599.45, 3701.023, 3701.024, 38854
3701.027, 3701.043, 3701.132, 3701.243, 3701.507, 3701.74, 38855
3701.741, 3701.881, 3702.30, 3702.31, 3702.51, 3702.522, 3702.591, 38856
3702.62, 3702.74, 3702.91, 3712.07, 3712.09, 3721.01, 3721.011, 38857
3721.021, 3721.022, 3721.024, 3721.026, 3721.042, 3721.071, 38858
3721.08, 3721.10, 3721.12, 3721.121, 3721.13, 3721.15, 3721.16, 38859
3721.17, 3721.19, 3721.21, 3721.28, 3721.32, 3721.50, 3721.51, 38860
3721.52, 3721.53, 3721.54, 3721.541, 3721.55, 3721.56, 3721.561, 38861
3721.57, 3721.58, 3722.10, 3722.16, 3727.02, 3742.30, 3742.51, 38862
3793.07, 3901.3814, 3903.14, 3916.06, 3923.122, 3923.27, 38863
3923.281, 3923.33, 3923.38, 3923.49, 3923.50, 3923.58, 3923.601, 38864
3923.70, 3923.79, 3923.83, 3924.41, 3924.42, 3963.01, 4123.27, 38865
4141.162, 4719.01, 4723.063, 4723.17, 4723.63, 4731.151, 4731.65, 38866
4731.71, 4752.02, 4752.09, 4753.071, 4755.481, 4758.02, 4758.04, 38867
4761.01, 4761.03, 4769.01, 5101.07, 5101.071, 5101.11, 5101.16, 38868
5101.162, 5101.18, 5101.181, 5101.182, 5101.184, 5101.21, 38869
5101.212, 5101.214, 5101.216, 5101.22, 5101.221, 5101.23, 38870
5101.24, 5101.243, 5101.25, 5101.26, 5101.31, 5101.35, 5101.36, 38871
5101.47, 5101.50, 5101.501, 5101.502, 5101.503, 5101.51, 38872
5101.511, 5101.512, 5101.513, 5101.514, 5101.515, 5101.516, 38873
5101.517, 5101.518, 5101.519, 5101.5110, 5101.52, 5101.521, 38874
5101.522, 5101.523, 5101.524, 5101.525, 5101.526, 5101.527, 38875
5101.528, 5101.529, 5101.5211, 5101.5212, 5101.5213, 5101.5214, 38876
5101.5215, 5101.5216, 5101.571, 5101.572, 5101.573, 5101.574, 38877
5101.575, 5101.58, 5101.59, 5101.591, 5101.97, 5103.02, 5107.10, 38878
5107.14, 5107.16, 5107.20, 5107.26, 5111.01, 5111.011, 5111.013, 38879
5111.014, 5111.015, 5111.016, 5111.018, 5111.019, 5111.0110, 38880
5111.0111, 5111.0112, 5111.0113, 5111.0114, 5111.0115, 5111.0116, 38881
5111.0117, 5111.0118, 5111.0119, 5111.02, 5111.021, 5111.022, 38882
5111.023, 5111.024, 5111.025, 5111.027, 5111.028, 5111.029,38883
5111.03, 5111.031, 5111.032, 5111.033, 5111.034, 5111.04, 38884
5111.042, 5111.05, 5111.06, 5111.061, 5111.062, 5111.07, 38885
5111.071, 5111.08, 5111.081, 5111.082, 5111.083, 5111.084, 38886
5111.09, 5111.091, 5111.10, 5111.101, 5111.102, 5111.11, 5111.111, 38887
5111.112, 5111.113, 5111.114, 5111.12, 5111.121, 5111.13, 5111.14, 38888
5111.15, 5111.151, 5111.16, 5111.162, 5111.163, 5111.17, 38889
5111.171, 5111.172, 5111.173, 5111.174, 5111.175, 5111.176, 38890
5111.177, 5111.178, 5111.18, 5111.181, 5111.19, 5111.191, 5111.20, 38891
5111.201, 5111.202, 5111.203, 5111.204, 5111.21, 5111.211, 38892
5111.22, 5111.221, 5111.222, 5111.223, 5111.23, 5111.231, 38893
5111.232, 5111.235, 5111.24, 5111.241, 5111.242, 5111.243, 38894
5111.244, 5111.25, 5111.251, 5111.254, 5111.255, 5111.257, 38895
5111.258, 5111.26, 5111.261, 5111.263, 5111.264, 5111.265, 38896
5111.266, 5111.27, 5111.28, 5111.29, 5111.291, 5111.30, 5111.31, 38897
5111.32, 5111.33, 5111.34, 5111.35, 5111.36, 5111.37, 5111.38, 38898
5111.39, 5111.40, 5111.41, 5111.411, 5111.42, 5111.43, 5111.44, 38899
5111.45, 5111.46, 5111.47, 5111.48, 5111.49, 5111.50, 5111.51, 38900
5111.52, 5111.53, 5111.54, 5111.55, 5111.56, 5111.57, 5111.58, 38901
5111.59, 5111.60, 5111.61, 5111.62, 5111.63, 5111.65, 5111.651, 38902
5111.66, 5111.67, 5111.671, 5111.672, 5111.673, 5111.674, 38903
5111.675, 5111.676, 5111.677, 5111.68, 5111.681, 5111.682, 38904
5111.683, 5111.684, 5111.685, 5111.686, 5111.687, 5111.688, 38905
5111.70, 5111.701, 5111.702, 5111.703, 5111.704, 5111.705, 38906
5111.706, 5111.707, 5111.708, 5111.709, 5111.7010, 5111.7011, 38907
5111.71, 5111.711, 5111.712, 5111.713, 5111.714, 5111.715, 5111.8438908
5111.85, 5111.851, 5111.852, 5111.853, 5111.854, 5111.855, 38909
5111.856, 5111.86, 5111.87, 5111.871, 5111.872, 5111.873, 38910
5111.874, 5111.875, 5111.876, 5111.877, 5111.878, 5111.879, 38911
5111.8710, 5111.89, 5111.891, 5111.892, 5111.893, 5111.894, 38912
5111.90, 5111.91, 5111.911, 5111.912, 5111.913, 5111.914, 38913
5111.915, 5111.92, 5111.93, 5111.94, 5111.941, 5111.942, 38914
5111.943, 5111.97, 5111.971, 5111.98, 5111.99, 5112.01, 5112.03, 38915
5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09, 5112.10, 38916
5112.11, 5112.17, 5112.18, 5112.19, 5112.21, 5112.30, 5112.31, 38917
5112.32, 5112.33, 5112.34, 5112.341, 5112.35, 5112.37, 5112.371, 38918
5112.38, 5112.39, 5112.99, 5115.02, 5115.10, 5115.11, 5115.12, 38919
5115.13, 5115.14, 5115.20, 5115.22, 5115.23, 5117.10, 5119.04, 38920
5119.061, 5119.16, 5119.351, 5119.61, 5120.65, 5120.652, 5121.04, 38921
5123.01, 5123.021, 5123.0412, 5123.0417, 5123.171, 5123.181, 38922
5123.19, 5123.192, 5123.198, 5123.211, 5123.71, 5123.76, 5126.01, 38923
5126.042, 5126.046, 5126.054, 5126.055, 5126.0512, 5126.082, 38924
5126.12, 5302.221, 5309.082, 5505.04, 5725.18, 5729.03, 5731.39, 38925
5747.01, 5747.122, 5747.18, 5751.081, 5815.28, and 5907.04 and 38926
section 5111.012 of the Revised Code are hereby repealed.38927

       Section 3. The organization of the Department of Health Care 38928
Administration as established by this act shall be in accordance 38929
with the business model, organization structure, cross-functional 38930
practices, information technology, state and local impact, fiscal 38931
and budget, transition, and long-term care recommendations as 38932
detailed in the Ohio Medicaid Administrative Study Council Final 38933
Report and Recommendations, as completed by the Ohio Medicaid 38934
Administrative Study Council in accordance with Am. Sub. H.B. 66 38935
of the 126th General Assembly.38936

       Section 4. On July 1, 2009, the Medicaid Program, Hospital 38937
Care Assurance Program, Children's Health Insurance Program, 38938
Children's Buy-In Program, and Disability Medical Assistance 38939
Program and all of the programs' functions, assets, and 38940
liabilities are transferred from the Department of Job and Family 38941
Services to the Department of Health Care Administration. The 38942
transferred programs are thereupon and thereafter successor to, 38943
assume the obligations of, and otherwise constitute the 38944
continuation of the programs as they were operated under Chapters 38945
5101., 5111., 5112., and 5115. of the Revised Code immediately 38946
prior to July 1, 2009.38947

       Any business of the programs commenced but not completed 38948
before July 1, 2009, shall be completed by the Department of 38949
Health Care Administration under Chapters 5160., 5161., 5162., 38950
5163., 5164., 5165., 5166., 5167., and 5168. of the Revised Code. 38951
The business shall be completed in the same manner, and with the 38952
same effect, as if completed by the Department of Job and Family 38953
Services under Chapters 5101., 5111., 5112., and 5115. of the 38954
Revised Code immediately prior to July 1, 2009.38955

       No validation, cure, right, privilege, remedy, obligation, or 38956
liability pertaining to the programs is lost or impaired by reason 38957
of the programs' transfer from the Department of Job and Family 38958
Services to the Department of Health Care Administration. Each 38959
such validation, cure, right, privilege, remedy, obligation, or 38960
liability shall be administered by the Department of Health Care 38961
Administration pursuant to Chapters 5160., 5161., 5162., 5163., 38962
5164., 5165., 5166., 5167., and 5168. of the Revised Code.38963

       All rules, orders, and determinations pertaining to the 38964
programs as they were operated under Chapters 5101., 5111., 5112., 38965
and 5115. of the Revised Code immediately prior to July 1, 2009, 38966
continue in effect as rules, orders, and determinations of the 38967
programs under Chapters 5160., 5161., 5162., 5163., 5164., 5165., 38968
5166., 5167., and 5168. of the Revised Code, until modified or 38969
rescinded by the Department of Health Care Administration. If 38970
necessary to ensure the integrity of the numbering of the 38971
Administrative Code, the Director of the Legislative Service 38972
Commission shall renumber the rules to reflect the transfer of the 38973
programs from the Department of Job and Family Services to the 38974
Department of Health Care Administration.38975

       Subject to the lay-off provisions of sections 124.321 to 38976
124.328 of the Revised Code, all of the programs' employees in the 38977
Department of Job and Family Services shall be transferred to the 38978
Department of Health Care Administration. The transferred 38979
employees shall retain their positions and all of the benefits 38980
accruing to those positions.38981

       The Director of Budget and Management shall determine the 38982
amount of the unexpended balances in the appropriation accounts 38983
that pertain to the programs as they were operated under Chapters 38984
5101., 5111., 5112., and 5115. of the Revised Code immediately 38985
prior to July 1, 2009, and shall recommend to the Controlling 38986
Board their transfer to the appropriation accounts that pertain to 38987
the Department of Health Care Administration. The Department of 38988
Job and Family Services shall provide full and timely information 38989
to the Controlling Board to facilitate this transfer. Any funds 38990
transferred under this section are hereby appropriated.38991

       Section 5. On July 1, 2009, the Residential State Supplement 38992
Program and Ohio's Best Rx Program and all of the programs' 38993
functions, assets, and liabilities are transferred from the 38994
Department of Aging to the Department of Health Care 38995
Administration. The transferred programs are thereupon and 38996
thereafter successor to, assume the obligations of, and otherwise 38997
constitute the continuation of the programs as they were operated 38998
under Chapter 173. of the Revised Code immediately prior to July 38999
1, 2009.39000

       Any business of the program commenced but not completed 39001
before July 1, 2009, shall be completed by the Department of 39002
Health Care Administration under Chapters 5160. and 5169. of the 39003
Revised Code. The business shall be completed in the same manner, 39004
and with the same effect, as if completed by the Department of 39005
Aging under Chapter 173. of the Revised Code immediately prior to 39006
July 1, 2009.39007

       No validation, cure, right, privilege, remedy, obligation, or 39008
liability pertaining to the programs is lost or impaired by reason 39009
of the programs' transfer from the Department of Aging to the 39010
Department of Health Care Administration. Each such validation, 39011
cure, right, privilege, remedy, obligation, or liability shall be 39012
administered by the Department of Health Care Administration 39013
pursuant to Chapters 5160. and 5169. of the Revised Code.39014

       All rules, orders, and determinations pertaining to the 39015
programs as they were operated under Chapter 173. of the Revised 39016
Code immediately prior to July 1, 2009, continue in effect as 39017
rules, orders, and determinations of the programs under Chapters 39018
5160. and 5169. of the Revised Code, until modified or rescinded 39019
by the Department of Health Care Administration. If necessary to 39020
ensure the integrity of the numbering of the Administrative Code, 39021
the Director of the Legislative Service Commission shall renumber 39022
the rules to reflect the transfer of the programs from the 39023
Department of Aging to the Department of Health Care 39024
Administration.39025

       Subject to the lay-off provisions of sections 124.321 to 39026
124.328 of the Revised Code, all of the programs' employees in the 39027
Department of Aging shall be transferred to the Department of 39028
Health Care Administration. The transferred employees shall retain 39029
their positions and all of the benefits accruing to those 39030
positions.39031

       The Director of Budget and Management shall determine the 39032
amount of the unexpended balances in the appropriation accounts 39033
that pertain to the programs as they were operated under Chapter 39034
173. of the Revised Code immediately prior to July 1, 2009, and 39035
shall recommend to the Controlling Board their transfer to the 39036
appropriation accounts that pertain to the Department of Health 39037
Care Administration. The Department of Aging shall provide full 39038
and timely information to the Controlling Board to facilitate this 39039
transfer. Any funds transferred under this section are hereby 39040
appropriated.39041

       Section 6. The amendments of sections 4723.063, 5112.01, 39042
5112.03, 5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09, 39043
5112.10, 5112.11, 5112.18, 5112.19, 5112.21, and 5112.99 of the 39044
Revised Code are not intended to supersede the earlier repeals, 39045
with delayed effective dates, of those sections.39046

       Section 7. The sections of law amended, enacted, or repealed 39047
by this act, and the items of law of which such sections are 39048
composed, are not subject to the referendum. Therefore, under Ohio 39049
Constitution, Article II, Section 1d and section 1.471 of the 39050
Revised Code, the sections go into effect July 1, 2009.39051

       Section 8. The General Assembly, applying the principle 39052
stated in division (B) of section 1.52 of the Revised Code that 39053
amendments are to be harmonized if reasonably capable of 39054
simultaneous operation, finds that the following sections, 39055
presented in this act as composites of the sections as amended by 39056
the acts indicated, are the resulting versions of the sections in 39057
effect prior to the effective date of the sections as presented in 39058
this act:39059

       Section 109.572 of the Revised Code as amended by Sub. H.B. 39060
195, Sub. H.B. 545, and Sub. S.B. 247, all of the 127th General 39061
Assembly.39062

       Section 1751.01 of the Revised Code as amended by both Am. 39063
Sub. H.B. 562 and Sub. S.B. 186 of the 127th General Assembly.39064

feedback